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.

 

How to Identify SSA Frauds

SSA’s Fraud Police

You answer a knock on your door, and find two strangers, one of whom is dressed in a police officer’s uniform. They inform you that you may be the victim of Identity Theft, as your ID was found in a den of thieves. Cause for alarm? Yes, but not for the reason you think. If you have applied for Social Security Disability benefits, you are likely the victim of a Fraud Investigation by the CDIU.

The Cooperative Disability Investigations Unit (CDIU) was jointly established by the Social Security Administration (SSA) and the Office of the Inspector General (OIG) in 1998, to prevent fraud. There are currently 28 CDIUs in 24 states, including Washington State. They accept referrals from SSA employees, Administrative Law Judges (ALJ), third parties, and even “anonymous sources.” (www.oig.ssa.gov) If these people want to talk with you, it is because someone suspects that you are trying to defraud the SSA.

The “identity theft ruse” is designed to get invited into your home and to get you chatting with the investigators. Ironically, CDIU agents are allowed to lie to you, in an attempt to prove that you are lying to SSA. They will also talk with your neighbors, friends and family, and often videotape your activities without your knowledge.

Reports generated by the CDIU often contain half-truths and inappropriate conclusions. For example: “W2 stated that Mr. Smith did not appear at all disabled to her.” Unless the anonymous Witness #2 is your doctor, her opinion is irrelevant – and yet your disability claim may be denied based on this CDIU report.

If you have a current claim for SSI or Social Security Disability benefits, and you suspect you have been the target of a CDIU investigation, notify your representative right away. If you are unrepresented, ask SSA for a copy of the CDIU report and all the videotape and interview transcripts. Be prepared to discuss the allegations in the CDIU report with the ALJ at your disability hearing. Depending upon the circumstances, you may also consider speaking with a criminal defense attorney, as these fraud investigations sometimes lead to prison.