SSD Appeals May Go From Bad to Worse

by Feb 28, 2017General

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SSD appeals backlog “solution” will likely cause more delays in the process

Applicants for SSDI benefits face many challenges. For many, who may suffer from a debilitating disease, chronic and painful physical disorders or severe mental impairments, simply working through the application and providing the information necessary for a successful application may be very difficult.

If you have a condition that has made working difficult or impossible, but is not easily diagnosed or identified, you are likely to be in for an unpleasant experience. Because you have to provide medical evidence that documents the condition or illness that prevents you from working, you may have to locate and organize a considerable number of medical records.

Medical evidence

You need your medical documentation to demonstrate your disability. The length of time, number of visits, they types of treatments, surgeries or other procedures, doctor’s diagnosis, and any prescription medicine you take, may all support your claim of disablity. If you have a condition that is made up of multiple impairments, you may have collect medical records from many healthcare providers that you may have seen over a period of time.

The complexity of this task means it is easy for mistakes to be made and documents to go missing. This is one reason two-thirds of Social Security Disability applications are denied. This is also why there are so many appeals and why the Social Security Administration (SSA) has a large backlog of these appeals. Also contributing to the backlog is insufficient funding by Congress of SSA, leading to an inadequate number of administrative law judges, who hear the appeals.

Ultimately, some appeals may end up in federal court. A court will sometimes return a case to a lower level adjudication, for the judge in that case to “fix” the determination according to the instructions of the federal court.

For SSD cases, this has typically meant the case is returned to the administrative law judge (ALJ) who made the original ruling. SSA, however, in an attempt to reduce the backlog at the ALJ-hearing level has proposed that instead to going to an administrative law judge, the case will be heard by an administrative appeals judge.

Who hears your appeal?

The problem with this is twofold. There is already a backlog of cases at the administrative appeals council level, so forcing these judges to hear lower-level remands will increase their appeals backlog. They will likely be slow in handling these cases, as they are not used to handling ALJ hearings.

Second, the administrative appeals judges do not have the independence that ALJs have and given they are being used in an effort to reduce the backlog of ALJ hearings, they will likely be under pressure by SSA to move as many cases as possible. The emphasis will be on quantity, not quality.

For applicants, this is bad news all around. It is unlikely that this move will result in a significant reduction in the ALJ backlog. It is very likely that it will result in a greater backlog at the appeals council level. Even worse, mishandling or questionable decisions by these reassigned administrative appeals judges could mean some of these cases may need to be appealed once again, back to federal court, further delaying the payment of any benefits to the applicant.

If your SSD claim is waiting on an appeal or has been remanded back from federal court, the attorneys at the Disability Advantage Group will aggressively examine any decision by an administrative appeals judge sitting in for an ALJ.

SSD claims and the process you must go through to obtain disability benefits can be long and difficult. Our attorneys will work with you through all of the necessary appeals to help you receive the benefits you deserve.