SSA’s Disability Caseload In Fiscal Year 2015

It takes SSA several months, and sometimes years, to adjudicate a disability claim. While this can be very frustrating for a disabled person waiting for an individual decision, SSA is not delaying claims on purpose – there is simply a very large caseload. The following is a summary of the numbers of cases, approvals and denials, decided in Fiscal Year 2015, organized by appeal level.

Initial Applications: 2,756,319 claims were received by SSA nationally.
2,677,870 Initial decisions were made by SSA
Of these, 33% claims were approved and 67% were denied

Reconsideration: 704,341 Requests for Reconsideration were filed after Initial Denial
701,072 Reconsideration decisions were made by SSA
Of these, 12% were approvals and 88% were denials

Disability Hearings: 746,300 Requests for Hearing were filed nationally
507,883 Decisions were issued by Administrative Law Judges
Of these 18% were dismissals and 37% were denials
45% of the claims were approved after a hearing

Appeals Council: 149,437 Requests for Review of Hearing Decisions were filed
116,078 decisions were issued by the Appeals Council
Of these, 4% were dismissals and 83% were denials
1% of the appeals were allowed and 13% remanded for
another hearing

Federal Court: 18,078 cases were filed in Federal District Court after AC denial
18,348 decisions were issued by the Court
Of these 8% were dismissals and 45% were denials
2% of the cases were remanded for payment of benefits,
and 45% were remanded for another disability hearing

SSA’s Disability Caseload In Fiscal Year 2015If you are waiting for a decision at any level of the process, we feel your pain. Know that you are not alone, however, and that the delays are neither intentional nor unusual. Although the waiting times vary considerably at different offices across the country, expect the following in Western Washington:

3-8 months at the Initial Level
1-5 months for Reconsideration
10-18 months for a hearing to be scheduled
12-24 months at the Appeals Council
8-14 months in Federal District Court

For more information contact Maddox-Laffoon today. We can help answer questions you may have about SSA and Disability benefits.

 

What to Expect at a Disability Hearing

WHAT YOU CAN EXPECT AT YOUR DISABILITY HEARING

After at least two appeals and months of waiting, you finally get an opportunity to meet someone who has the authority to declare you disabled. This person is an Administrative Law Judge (ALJ), and the opportunity is your disability hearing.What to Expect at a Disability Hearing

You are likely nervous about the hearing, but you should know that it will probably not be as scary as you think. Disability hearings are usually held in small conference rooms, and are not public. The only people in the room will be you, the ALJ, your representative (if you have one), a hearing monitor who runs a recording device, and sometimes a medical and/or vocational expert.

The administrative hearing is not as formal as a court appearance, but your testimony will be taken under oath, so the first thing the ALJ will do is swear you in. He or she will then review the exhibit list, with you or your representative, to ensure that all your medical records and any other evidence you want considered is in your file. Then the ALJ will start asking you questions.

Some ALJs may ask a general question, such as “why do you believe you cannot work?” but most of the time the questions are smaller and are designed to elicit specific information. For example, the ALJ may ask where on your body you have pain, how much weight you can lift and carry, whether you need naps, if you have problems getting along with others … and similar questions that relate to your specific impairments. If the ALJ asks “why do you believe you cannot work?” he or she is really asking what your symptoms are, and how they affect your ability to do things. The ALJ has already reviewed your medical records, and is aware of your diagnoses.

You will likely be asked questions that may not seem relevant to your impairments, but which are important for the ALJ to know, for example:

  • Your education
  • Your work history (for the past 15 years)
  • Any criminal history
  • Your living situation
  • Your activities of daily living
  • Any drug or alcohol use

It is important that you answer all questions honestly. Most ALJs hear at least 500 cases a year, and have a pretty good sense about when someone is lying to them. Even if you believe the answer will not be flattering, you still need to tell the complete truth.

What to Expect at a Disability HearingIf you do not know the answer to an ALJ’s question, you should say so. Do not make something up, or “guess” just to have something to say. If you do guess, or make an estimate, make sure you tell the ALJ that this is what you are doing. Also, be very concrete in your answers. Stay away from absolute words like “never” or “always.”

After you have answered the ALJ’s questions, your representative will usually ask you follow-up questions. This is a good opportunity for your representative to help clear up any inconsistencies and flesh out details about your symptoms and limitations.

If you wish to have a friend or family member testify on your behalf, that is usually done after you testify. Most ALJs sequester lay witnesses – make them sit in the waiting room while you testify, so they do not simply repeat what they heard you say. Some ALJs prefer not to hear lay testimony, in which case you should have a discussion on the record about this. Sometimes an ALJ will ask you to present the lay testimony in a written statement instead. If that happens, make sure you get the written statement in as quickly as possible. If you wait more than a day or two, the record will likely be closed without that evidence.

If there is a medical expert (ME), either in person or by telephone, the ALJ will ask them what their take is on your medical or mental health impairments. You or your representative will have an opportunity to cross-examine the ME.

If there is a vocational expert (VE) at your hearing, the ALJ will ask them to classify your past work, using the Dictionary of Occupational Titles. Usually the ALJ will ask the VE hypothetical questions, to determine if someone with your particular limitations can do any job that exists in the U.S. You or your representative will have an opportunity to cross-examine the VE and ask your own hypothetical questions. Usually the VE is the last person to testify.

Most hearings take about 45 minutes, but there is no official time limit. If you feel you need to give the he ALJ more information about your conditions, he or she will likely give you as much time as you need.

Most ALJs do not tell you at the hearing whether or not you won. You must wait for the written decision, which is usually issued within 1-3 months after the hearing. Call us if you have more questions or need assistance on any disability case in Grays Harbor, Olympia or Thurston County.

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