Why does it take so long to get a decision after a hearing for Social Security Disability?
The mystery of all great Social Security mysteries is WHY it takes so long to get a decision. Now, before you go and start blaming the government or your representative or your doctor, recognize a few things.
First, Social Security is in the process of going completely paperless. And let me tell you, this is going to shave a HUGE amount of time off of your case. Now, the local offices, the hearing office, and the medical determination offices all have the ability to look at your file for a variety of information. I don’t know how many of you have ever seen a file for someone who goes to the VA but WOW, back in the day, you could have a paper file that was HUGE (we’re talking 10 pounds easy). Now, everything you need can be put on a disk.
Second, with the processing being paperless, it is easier to transfer your file from place to place if need be. Back in the day, you had to literally MAIL the folder to the hearing office and then the office had to receipt the file. Imagine how long this process used to take.
Finally, Social Security is actively sharing the wealth. It used to be that one office would be responsible for an area and so, as you can imagine, some areas had smaller case loads than others. Now, Social Security is spreading the wealth to other offices and having hearings via video teleconference. You could live in Arkansas and have a judge from Washington (Trust me, the regulations are federal so they are world wide).
NOW, back to your question as to WHY it takes so long AFTER you have a hearing, here’s a few things to consider:
1) New records, not in evidence.
Remember, at the hearing level, YOU have the responsibility of providing records to the court. So you can imagine the number of times people get to court and either a) they bring in new records, b) they mention records that they need to get and the court to consider and/or c) they requested records and they are waiting for them. You have to remember that the courts want to make an informed decision. As such, the court may decide to allow you the opportunity to get those records. Now, I hope you don’t think that the judge has made their decision and will finish it up once you send them the records. The court has a duty to weigh ALL of your evidence so they have to look at what you provided and compare it to what’s in the file. This process may take a while.
2) CE
Follow me on this procedure. You’re in a hearing and the judge decides that you need to go to a Consultative Evaluation (don’t freak, this is usually in your best interest). SO, they order it in court. After the court hearing is over, one of their staff drafts the order. The judge signs it and tells you that you will be scheduled by a Medical Determination Service (this can take about 2 weeks to 3 weeks to get this letter). The Medical Determination Service gets this letter and then looks for the specific type of doctor that you need. They then schedule the appointment based on the doctor’s availability (This can take a few months) and then notify you. You go to the doctor. Within 30 days (usually), the doctor sends back a report to you (if you don’t have a rep) and the judge. You can either agree to it, contest it or ask for another one (you are usually given 10 days to respond). Then the judge has to consider this report with the other medical evidence. Now, in theory, from the time you had your court hearing to the appointment for the CE and the report to come back, at least 4 to 5 months have passed. And the court still has to review the findings. The judge could ask you to come back for another hearing.
3) Supplemental Hearing
Hear me when I say this “If the judge wants to have a SUPPLEMENTAL hearing, there’s not a DAMN THING you can do about it!”. People sometimes forget that the judges have a responsibility to ensure that the decisions properly weigh the evidence. As a result, the judge has the discretion to ask you to come back if he or she needs more info. TRUE STORY, I represented a client that had one hearing and two supplemental hearings after the first one. At the first hearing, the judge was reviewing the evidence and determined that we needed a vocational expert. At the second hearing, the judge determined we needed an additional psychiatric and neurological expert. I kid you NOT. It took a year and a half to go through all 3 hearings AND receive the decision. Now, that’s not a YEAR and A HALF from the start of claim. That’s just the hearing process from the date of the hearing. Supplemental hearings like this one are rare but they can happen.
4) Conflicting evidence
IT is AMAZING how people don’t realize that sometimes, the hardest part of the case is when there is evidence that is conflicting. What do I mean by “Conflicting”? For instance, you got one doctor that says you have bad breathing problems and that even if you stop smoking, you would be in bad shape. You got another doctor saying that you would be better if you stopped smoking. Two different doctors saying two different things. WHO do you believe? Now, that example was clear cut but there are many other times when your medical records provides conflicting information and the judge responsibility of trying to resolve this conflict. Unfortunately, you can’t do this quickly.
5) DAA
DAA - Drugs AND Alcohol. I’ve seen some GREAT cases drag out because somebody wouldn’t put the bottle down or get off the pipe. And just to let you know, Marijuana is only medicinal if it’s PRESCRIBED, not because the ganja makes you feel better about your conditions. As a result, people fail to recognize that anytime you are using Drugs and Alcohol, the court has to determine if this materially affects your ability to return to work. It’s one thing if you haven’t used drugs or alcohol in years. It’s another if you just got off the pipe last week and you want the court to consider that the fact that you’ve been clean for 7 days.
6) Large case load (the Judge to the Writer to the Editor to the Judge THEN to you)
Bottom LINE, my friends, Judges have a HUGE case load. As a result, it takes a while to receive a written decision. Here’s how it will go. The judge has to review the evidence and make a decision. The decision is sent to a decision writer. The decision writer is usually writing for several judges which means that they probably process their decision based on age (the oldest first). After the decision is written, the judge has to review. If it’s cool, it goes to the editor. Back to the judge for a signature and THEN, to you! See, I told it takes a while!
7)Once it’s in the judge’s hand, there is nothing your representative can do (most of the time).
If you have a representative, please recognize that there is probably nothing more than can do. They have gotten all of the evidence into the court. It’s in the court’s hands. More importantly, there is nothing YOU can do. So please don’t think that you calling the court every day or sending faxes to the court is going to make a difference. At the end of the day, the process must go through. Now, i know you noticed that I said there is nothing your representative can do (most of the time). If you have a critical situation (ie foreclosure or eviction), your representative may be able to ask the court to expedite the case. In some instances, the court may permit your representative to file a proposed decision (if it’s favorable). However, everything rides and falls with the court.
I know this process is a beast but it’s the only one we have so you need to be aware of the pitfalls and the perils of the process so you don’t get too overwhelmed.
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.
Myths about Social Security Disability: What happens between the HEARING and getting your written decision
The hearing process of Social Security Disability can be very nerve racking but it shouldn’t be. Once you have the hearing, the only thing you need to do is wait. However, there are some myths that some people believe that you really need to keep in its proper perspective:
1) MYTH - It’s going to take a year or longer before I get a written decision.
People fail to realize that Hearing Offices understand that you’ve waited a long time to get your hearing date. As such, they are going to take every effort to process your case as soon as possible. They can’t give you a definite time but please don’t think that your case is going to linger in ‘never, never’ land for years.
2) MYTH - The judge said I’m going to get my decision in ______ days.
As stated in a prior post, you have to remember that several people are involved in your decision. The judge makes the decision. The writer writes the decision. The editor edits the decision. The judges reviews the final decision. The staff assemble the decision and mails it out. With so many steps and so many files, some times it’s difficult to appreciate how long it takes to make a decision.
3) MYTH - The judge TOLD me that I was approved so I KNOW I’m getting a favorable decision.
I’ve said it ONCE, I’ve said it a THOUSAND times. The decision hasn’t become FINAL until you get a WRITTEN decision. Now, keep it mind (as I’ve said before), Judges are very straightforward. However, after reviewing your file or if they get new evidence, the judge may re-evaluate his or her decision.
4) MYTH - If I keep calling every day, it will speed up my decision.
I have to constantly remind people that the staff at the hearing office are people, too. These people are tasked with trying to generate hundreds of decisions a day to people who are waiting for their decision. So do you really think you are going to help your situation by constantly calling the office and keeping them from doing their job? (Use some logic. What do you do when a bill collector calls you ever day on your phone? Don’t get new! Some of you won’t even LOOK at the phone!)
5) MYTH - They have all the evidence they need. They don’t need any more.
If your case has some inconsistencies, the judge may order an evaluation. In addition, if you have some extra evidence that is helpful, they may have to review your file with the new evidence that is provided.
6) MYTH - The expert in the court said I could (or could not) work so I know I am not going to win (or lose).
Typically, in Social Security hearings, you may have a Vocational Expert or a Medical Expert. These persons are there to provide expert opinions about the ability of persons to do work (Vocational) or give opinion about the medical evidence (Medical). However, these persons are NOT the final decision maker. The judge is the final decision maker.
7) MYTH - If I call the hearing office, they will tell me if I’ve won or loss on the phone.
Most people don’t realize that Social Security has a very strict policy AGAINST informing people about the decisions on the phone. So, please don’t think that they are trying to single you out by not telling you.
MYTH - There is NO way I can speed up my decision.
I hate telling people this because it usually doesn’t make them feel better but if you are not Terminally Ill or in a Critical Financial Situation (i.e. eviction or foreclosure or homeless), Social Security is probably not going to move any faster on your case. Why? Because several THOUSAND people are in the EXACT same spot as you!
9) MYTH - My case will move to the top because my Congressman / Congresswoman / Senator is involved.
Ok. If you went to your Representative or your Senator, your case may have moved a little faster to get TO the hearing level. However, once it’s there, it’s in the hands of the judge and judges tend to not be swayed by Congressional pressure. Every person is equally as important (with or without the Congressional pressure).
10) MYTH - If I get denied, there’s nothing more I can do.
WRONG! You can always appeal! Remember, you have 60 days from the date of the decision to appeal.
11) MYTH - If I get approved, I win for good.
WRONG AGAIN! Two things can happen. One, the Appeals Council can pull your case for review (just checking to make sure that the decision was right). Two, you will undergo a Continuing Disability Review (unless you’re 63 or 64) every 3 to 5 years to make sure you’re still disabled.
12) MYTH - My case is exactly like my Friend’s case and he / she got approved so I should, too.
Everyone’s case is on a case by case basis. Please don’t compare your case to someone else’s case. The last thing you want to do is think that your case will have the same outcome of someone else’s case (and contrary to popular belief, you haven’t seen your friend’s file so you don’t know what got them approved).
The Social Security Disability process can be confusing. However, it can be more confusing if you allow yourself to believe alot of the myths that are out there. Remember, the process is designed for you. Don’t let it get away from you.
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.
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