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.
