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.
Explain to me about the Social Security Administration “APPEALS COUNCIL”
Alot of time, claimants spend a great deal of time and energy dealing with the Local Social Security Administration office and the Hearings Office. Very few people have even heard of the APPEALS COUNCIL (AC) until they get denied for Benefits by an Administrative Law Judge.
For those of you who have never heard about the Appeals Council, here’s some information to help you:
1) What is the “APPEALS COUNCIL”
The Appeals Council is the administrative appeal body within the Social Security Administration that is responsible for reviewing the decisions of the Administrative Law Judges. They are responsible for handling appeals of Administrative Law Judge decisions and handle reviews of decisions on their OWN motion.
2) What does it mean to be ‘Reviewed by the Appeals Council’ on its OWN Motion?
Most people don’t realize that even if you get approved by an Administrative Law Judge for benefits, that decision is subject to review by the Appeals Council. In any judicial process, every judge must answer to a judge who is higher than he/she. The Appeals Council reviews all decisions (randomly) to ensure that the judges are rendering the proper decision.
3) What happens after this review by the “Appeals Council”?
Four things can happen after their review. One, the Appeals Council can determine that the Judge made the right decision. Two, the Appeals Council can determine that the Judge made a PARTIALLY right decision and send the decision back to the Judge to correct it. Three, the Appeals Council can determine that the Judge made a wrong decision and send the decision back to the Judge to correct it. Four, the Appeals Council can make its own decision and not send the case back to the judge.
4) If the Appeals Council pulls the case for review on its own, how long do they have to make a decision?
Typically, the AC will indicate that they must make their decision within 110 days. During those 110 days, your ability to obtain any benefits approved by the SSA will be held until they make their decision.
5) How long after getting a Favorable decision from SSA will you have to wait in order to determine if the AC will pull it for review?
The AC can pull a case for review at any time. However, the AC recognizes that people have waited for a long time to obtain benefits so they tend to move quickly in making their decision.
6) What happens after 110 days if they haven’t made their decision?
After 110 days, the claimant has the option of requesting the SSA to go ahead and process their favorable decision from the Administrative Law Judge. This way, the claimant can receive their benefits while waiting for their review from the AC.
7) Can the AC reject the ALJ decision and take the benefits back?
It is possible. If the AC determines that the ALJ was wrong and sends the case back to the ALJ, the ALJ can reverse his/her decision. Unfortunately, this means that you may have to reimburse Social Security for any benefits that you may have obtained.
What if the Judge denies my case, can I appeal to the AC?
The AC is the final administrative decision maker. If the judge denies your case, the next level is to ask for a Review of the Judge’s decision with the AC.
9) How long will it take to get a decision from the AC regarding my appeal of my denial from the judge?
Unfortunately, this question doesn’t have a simple answer. Most people don’t realize that the Appeals Council handles decisions for the entire country. As a result, it takes a while (6 to 12 months) for the Appeals Council to make their decision.
10) If the AC denies my appeal, is that the end of my case???
No, you can file a Civil Action in the United States District Court. In essence, you would be suing the Social Security Administration for getting the decision.
The process regarding Social Security can confusing but these extra tidbits can go a long way to helping you under.
What happens after the Social Security hearing and beyond??
This post focuses on what happens after a Social Security Hearing and what happens if you win:
1) Nothing happens until it’s writing.
So after months and months of waiting, you finally go to your Social Security Disability hearing. You got prepared. You took all of your medical records. You gave your testimony. Now what?? Very simple. You wait! NOTHING, and I repeat, NOTHING will happen with your case until you get a written decision from the judge. The written decision directs the Social Security Administration on what to do with your case.
2) They say _____ days but that’s just a guess.
In some hearings, the judge may give you an “APPROXIMATE” time of how long it will take to get a written decision. Please note that I emphasize “APPROXIMATE”. Please don’t walk out of the hearing thinking that the judge is GUARANTEEING that you get the decision in the days the judge said. Here’s why. First, if you have any records outstanding, they may wait on those records. Second, the judge has to give their information regarding the decision to a ‘writer’ who will write the decision. I hate to tell you but there are usually only a few writers for several judges who have to handle hundreds of cases a piece. Third, after the decision is written, the judge has to review the decision. Finally, after the judge gives the ok, it goes and gets a final edit and then released to you. In the best case situation, this can be a few weeks. I’ve had a few that lasted up to 6 months. It just depends.
3) You can’t rush the judge so why bother.
Listen, the JUDGE is the final decision maker and you CAN’T act a fool with the judge. Remember all those times you were blowing up Social Security phone line demanding your case to be processed or moved forward, well you’re at the final destination and the Judges take their role of evaluating your case seriously. And most importantly, the JUDGE is the LAST person you want to harass about your case. They already know how important it is and how long you’ve been waiting so ‘chill out’ and wait.
4) Just because they SAY you’re approved don’t get the high pro glow.
Judges rarely will tell you that you’re approved at the hearing. However, in some instances, they may tell you. However, it’s important to remember (as stated at point #1) that you need to wait until you get the written decision. Am I saying that a judge will lie? NO, that’s not what I’m saying. However, a judge can review your information and change their mind after reviewing everything again so wait until you see the decision.
5) Now, you got it, here’s what the language means: Alot of times, people will get the decision and not fully understand what all of the extra language means. Here’s a quick down and dirty of what you’re looking -
a. Fully Favorable / Partially Favorable
On the very first page, you should see something that says Fully Favorable or Partially Favorable. Fully Favorable means that you got everything you asked for in your request (In terms of your disability date and eligibility for programs from a disability standpoint) and Partially Favorable means that you win but the Social Security Administration disagree with the full extent of what you’re asking. You may get something but not the full amount of what you were expecting.
b. Appeals Rights
Under the regulations, you have 60 days to appeal the decision. Usually people don’t appeal a Fully Favorable but you can appeal a decision. It is your right.
c. Appeals Council can review
Most people don’t realize that there is a judicial body that oversees the judge’s decisions and can render a decision regarding a case. In some instances, the Appeals Council can pull a decision to determine if the judge makes the right decision. What does that mean? If the Appeals Council has a problem, they can make the judge (and you) have the hearing again because of a discrepancy.
d. SSI means the date of the application (that’s when you get paid)
If you have a Supplemental Security Income case, your application date is crucial because that’s the date Social Security will start paying you.
e. DLI doesn’t mean that’s when your disability will run out
These initials stand for “Date Last Insured” and this date almost ALWAYS throws people for a loop. This date does NOT mean that this is when your disability will run out. It is an insurance date. Remember, when you are applying for disability on your earnings, you have to demonstrate you became disabled within a certain period of time. That period of time is anytime before your DATE LAST INSURED. So when you see that date and the decision says “date last insured”, as long as you became disabled before that date, you should be fine.
6) Who is going to pay you???? This part is even more confusing because sometimes people don’t know when they are going to get paid -
a. SSI - Local Office
If your claim was for Supplemental Security Income ONLY, the local office that handled your claim will be the only office handling your payments (Unless you moved).
b. DIB - payment center
If your claim was based on your earnings, a payment center (usually in Baltimore, Birmingham, or Jamaica-NY, etc.) will be responsible for handing your payments.
c. Concurrent - a little of both (this one takes awhile)
Here’s how it gets tricky. If you qualify for both programs, the SSI portion has to go through the local office and THEN, the case gets transferred to the payment center to handle the other portion. It’s tricky because they both rely on information from each other so if one office is missing something, this may hold up payment on both ends.
7) How long? Stop rushing them, you gonna get your money
This statement may seem cold but recognize “You gonna get yo money”. I say that because SSA recognizes that once you’ve been approved, you have a burning desire to get your money as soon as possible. I typically tell people to give it 60 to 90 days to get everything in the system. In that time, you should get your back pay, start getting your monthly pay, and additional information.
What are these letters from SSA??? Notice of information? Awards Notice?
Social Security is going to send you alot of information about how much money you’re going to get and when you’re going to get it. If you happen to get your money FIRST, don’t freak. It happens like that sometimes. Just know that SSA will make sure that you’re informed.
9) Make sure you have your documentation that they need or your money WILL go slow.
Remember, SSA is going to ask you for alot of information so if you’re slow on the draw regarding providing that information, you could hold up your case.
Yes, Yes, I know it’s amazing all of the things you have to do but recognize, in the end, you will be happy you receive your benefits.
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