September 17, 2009

Initial Evaluation of Your Social Security Disability Claim

disability.JPGIndiana Social Security disability claimants are often unaware of how their claim is evaluated by the Social Security Administration (SSA).  Indianapolis Social Security Disability Attorney Scott D. Lewis often explains the evaluation process to his clients. 

Scott recommends that once you become disabled, you file your  Social Security Disability Insurance (SSDI) claim immediately with the SSA.  Once your claim has been submitted to the SSA, an employee of the SSA will determine if you meet the basic requirements for disability benefits.  The SSA will look at the following basic requirements:

  • work history (evaluating whether you have worked long and recently enough to be insured for SSDI),
  • age,
  • who you are applying for (evaluating whether you are applying for yourself or as a family member of another who is disabled), and
  • current monthly income (a maximum exists on how much you can earn each month and still qualify for disability benefits).

If you meet the basic requirements, your claim is forwarded to the state Disability Determination Services (DDS) office for review. The DDS office makes the initial determination regarding your disability claim. The DDS team may consist of the following:

  • a physician
  • a psychologist, and
  • other disability specialists.

Before making a decision an examiner will request any missing health documents from your health care provider and will determine if the DDS has all the information and documents needed to make a determination of your claim.  The DDS may also request other information they believe is necessary to properly evaluate your disability claim. It is very important you provide current contact information and that you provide as many documents as you can to speed up the evaluation of your disability claim. 

Sometimes, the DDS determines that the claim can not be properly evaluated based on the available information and documents.  The DDS may ask you to attend a consultative examination. Even though the consultation may be performed by another doctor, it is preferable for your primary physician to perform the examination. Therefore, it’s recommended that you ask the DDS to allow your physician to perform this exam.  The DDS may agree if your physician is qualified and has the resources.  During the evaluation, the DDS will carefully consider:

  • all of your health problems,
  • work experience,
  • education, and
  • age.

The DDS essentially considers the following in making its determination:

  • the disabling diagnosis,
  • severity,
  • how long you have been disabled,
  • how the disability limits your activities (work related, ability to walk, stand, sit, bend, kneel, lift, use your hands, and remember instructions)
  • other disabling factors (such as chronic pain or fatigue), and 
  • prescribed medications and their effect on your ability to perform any work-like activities.

The initial evaluation process may take six months or longer before the DDS renders a decision on your disability claim. Attorney Scott D. Lewis advises his clients to be prepared for your disability claim to initially be denied.  Majority of all disability claims are denied after the initial evaluation by the DDS. Claimants will receive a determination letter informing you of the results. The letter will inform you of the benefits amount and date of first payment if your disability claim has been approved, or the reason why and method of appeal if your claim was denied.

If you have additional questions regarding the evaluation process or if your initial claim has been denied, contact Social Security Disability Attorney Scott D. Lewis for a free consultation at (317) 423-8888.

Filed under:Claims Process