Monday, May 25, 2009



Appealing a Social Security Disability Determination (Onset)

In response to the post before this one (Social Security Disability Notice of Award Question ), another comment was left and another issue raised. Here are the comments and the response that follows immediately after.

I recently appealed my disability onset date after being approved at initial application (and review at the DQB); there is a six month time difference. I appealed because they did not request all of my medical records in making the initial determination (I supplied as many as I could, but it became very expensive!). On reconsideration, my onset date was changed at the local office but denied at the DQB and I'm now trying to decide if I should pursue it to the ALJ level as my disability case itself has now withstood what amounts to 4 reviews (initial approval, DQB, recon, DQB) and I'd just like them to look at the onset date. The other thing is that the letter I received after the most recent DQB review fails to recognize a key set of medical records that I'm not sure they considered. It is a difficult decision but affects medical insurance and is a significant amount of money.

When I first read your question, I almost had to wonder if the question was being posed by a disability attorney or a disability claimant. Simply because Social Security disability examiners and claims representatives are not really allowed to inform disability claimants of any decisions sent to disability quality review and disability claimants do not receive this kind of information in their decisional notices.

However, in response to your question, the choice to pursue an onset appeal is always in the hands of disability claimants and/or their disability representatives. It is impossible for me to advise you to pursue your onset appeal or to refrain from doing so. I can only say that every time an individual appeals an onset date they take the chance of having their disability claim decision reopened to a denial.

With regard to "key evidence", I would suggest that often disability claimants consider certain pieces of medical evidence as important indicators of their disability, when in actuality disability examiners and for that matter administrative law judges do not.

You did not state in your question if you actually provided Social Security with your key set of medical records. If you did, then disability quality review examiners most likely considered them in their determination. If you did not provide those records, I am not sure why you acquired other medical records and not those that you deem key to your disability onset.

Of course, a change of onset does make a difference in monetary benefit back pay and the date of Medicare entitlement. And as you stated in your question your disability claim has stood four other reviews.

The decision to pursue this to an administrative law judge has to be your decision, however you should consider this: your disability claim has never been reviewed by an administrative law judge. Even though you only wish them to consider the time frame between your alleged date of disability onset and their established date of onset, they are going to examine the entire disability claim when they make their disability decision.


Return to the Social Security Disability SSI Benefits Blog




Other Posts

Social Security Disability - Back Problem, Depression Issues
Will the Judge ask me any questions at my Disability Hearing?
My Disability Claim was Denied, Should I Reapply?
Hearings for social security disability - how do you file for a hearing
Is it worth appealing a Social Security Disability denial by an Administrative Law Judge?
The purpose of the Administrative Law Judge in Social security disability and SSI cases
Administrative Law Judge (ALJ) Decision - is it the end?
Why does it take so long to get a decision on a Social Security Disability or SSI Disability case?
How long does it take to get a disability decision ?

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2 Comments:

Blogger Self said...

Thank you very much for your response. I didn't realize I was not supposed to know that my claim went for review! I did carefully timed follow up with the rep assigned to my case (based on when I thought they should have received medical records and such) and was informed of when they had signed off on my case and when I should expect to hear something in writing. When I followed up with the local office, I was told that my claim had gone for review. It was that simple. I took your advice (I've followed your blog and the NOLO guide very carefully) and have always been very polite and courteous, and it's apparently paid off with my being well informed.

With regard to my medical records... I have multiple providers and the one that I could not provide records for charged very high copying rates. I requested my records and the quote was a few hundred dollars. I had them hold it for SSA to request them and they never did (even the second time around when I specifically highlighted them since they missed them the first time around). I imagine if I go the ALJ route, I'll have to ante up and obtain these records myself.

Thank you again. I appreciate it.

4:19 AM  
Blogger Self said...

I just re-read your comment with regard to "key evidence." I wanted to note that the medical records in question are from one of two treating sources during the time period for which I was requesting a reconsideration and my records from that particular treating source are very extensive (hence, the cost) which is why I feel that those particular records are so important.

Thanks again!

6:28 PM  

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