Social Security Disability:

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Disability According To Social Security

Congress has defined disability as the "inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months. To meet this definition, you must have a severe impairment, which makes you unable to do your previous work or any other substantial gainful activity which exists in the national economy. To determine whether you are able to do any other work, we consider your residual functional capacity and your age, education, and work experience."

From this definition has emerged a standard set of questions which must be asked of each claimant (the person who is applying).

1. Is the individual gainfully employed? The answer to this must be "no."

2. Is there a severe impairment (or group of impairments) which exist?

3. Will the impairment(s) last at least 12 months or result in death?

4. Does the impairment meet any of the standards set by SSA as being severe enough to grant disability?

If questions 2, 3, and 4 above can be answered "yes," then that person will be awarded benefits. If all of the above questions, except number 4 can be answered "yes," then several more questions must be asked. If the answer to number 4 is "no," then SSA must ask:

5. Can the individual perform any of the work s/he has done in the last 15 years? If the answer to this is "yes," then that person is considered not disabled. If the answer to number 5 is "no," then SSA must ask:

6. Given the limitations of the individual's impairment, are any of the skills s/he learned in past work able to be used in another occupation that would require very little retraining? If the answer to this last question is "yes," then that person is not disabled. If the answer is "no," then s/he must be found disabled.

All of the above is based on certain definitions, assumptions, and conditions which pertain to age,education, work experience, and residual functional capacity.

Age

In general, SSA operates on the assumption that the older one gets, the less able s/he is to learn new skills. An individual under the age of 50 is referred to as a "younger individual." Ages 50 to 54 are called "closely approaching advanced age;" 55 and over is "advanced age," and ages 60 to 64 are called "closely approaching retirement age."

Education

SSA makes the assumption that the more education one has, the better able s/he is to make adjustments in jobs. Conversely, the less education, the less able one is to adjust. So if one has a severe impairment, and cannot read or write, s/he should be found disabled.

Education through the 6th grade or less is termed "marginal;" 7th grade through the 11th is "limited." If one has a 12th grade education or a GED, then the question remaining is whether or not s/he has done work which permits entry into another group of jobs which require many of the same skills as s/he was doing before, or less.

If there are jobs in the economy which are related in skills to the one(s) s/he was doing within the last 15 years, and which s/he is determined capable of doing given the limitations imposed by the impairment(s), then s/he will not be found disabled.

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    The latest processing times for Social Security disability cases have hit new all-time highs. The average lengths of time up to May of 2008 for Social Security disability claimants to get a hearing after a hearing is requested, has been received from the Social Security Administration through

    the Freedom of Information Act. The average length of processing times for 141 hearing offices is 16.8 months. Long delays in processing cases is the number one complaint leveled by patient-claimants against the Social Security Administration. Despite former commissioner Jo Anne Barnhart's pledge to speed up processing times with the use of electronic technology, they have in fact lengthened to an all-time high. However, the conversion is not completed, and is still in process.

    In 2008, only one of the 141 hearing offices met the Administration's goal of 250 days (8.3 months) from the time one asks for a hearing to the time one gets a hearing-Stockton, CA.

    Offices taking between 10 and 11 months are Hartford, Providence, Charleston, WV, and Dover.

    Processing times between 11 and 12 months were achieved by Boston, Huntington, Richmond, VA, Salt Lake City, Los Angeles Downtown and West, and Orange.

    Those hearing offices achieving average processing times between 12 and 13 months are New Haven, CT, Portland, ME, Queens, San Juan, Johnstown, Philadelphia, New Orleans, Kingsport, TN, Billings, Pasadena, San Bernadino, San Francisco, San Rafael, Santa Barbara, and Tucson.

    The slowest processing time was 2 years, 4 months, for Columbus, OH. Other worst offenders are Oak Brook (29 months), Lansing (27.3 months), Greenville, NC (27 months), Indianapolis (26 months), Cleveland (25 months), Dayton (25 months), Flint (24.6 months), Peoria (24.2 months), Oak Park (24 months), Evansville (24 months), and Madison (23.4 months).

    The Social Security Administration has set a goal of eliminating all pending hearing requests that are 900 days old or more. Last year, the Administration set a goal of eliminating all cases that were 1,000 days old or older, which was successful. At the beginning of fiscal year 2008, which began in October of 2007, there were 134,000claims that were 900 days old or older. By the end of May, the number had been whittled down to 28,000. As of now, no goal has been set for 2009.

    Additionally, SSA's Office of Quality Assurance is identifying cases which should have been allowed before being appealed to the hearing level. 8,700 of these cases were found in FY 2007. The office is hoping to find 17,000 of these types of cases this year. States being targeted are those with the greatest number of paper (non-electronic) cases, which include New York, Georgia, North Carolina, Florida, Indiana, and Ohio.

    SSA has also ushered in 135 Administrative Law Judges and plans to hire 50 more. Representative Kathy Castor (D-FL) introduced a bill in July which would require SSA to issue a hearing decision within 90 days after asking for a hearing. Her district includes Tampa, FL, which has one of the longest processing times with 21.6 months. The "Timely Due Process for the Disabled Act of 2008," H.R. 5485, would require that the claimant would receive notice of a hearing within 5 business days after the request for a hearing is filed, that the hearing would be held within 75 days after the request for a hearing is filed, and that the ALJ would issue a decision within 15 business days after the hearing.

    In the meantime, while SSA is paring down the backlog, there are 4 conditions which should put a case closer to the front of the line. They are::

    1) The patient is terminally ill;

    2) The patient is without, or is unable to obtain food, medicine, or shelter, or;

    3) There is an indication that the patient is homicidal or suicidal;

    4) The case has been delayed an inordinate amount of time, longer than the average processing time.

    The patient-claimant should address his or her circumstances to the Chief Administrative Law Judge via certified mail. After sending, a follow-up call should be made to find out whether the change of status has been made. If not, you should mention your mailing date and the date of receipt, as well as the your reasons for requesting the change in status.

    Social Security Disability Self-Evaluation

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    Here's a short quiz that will help you determine what your chances are of being found disabled.

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