Monday, April 11, 2011

The Initial Application Process: An Explanation

                The first step when applying for Social Security Disability Benefits in San Diego begins with the initial application. This process takes roughly 4-6 months to have a decision made. The initial application can be filed online or at the claimant’s local Social Security Office. The application includes detailed information regarding your condition and work history. Once the initial application is filed, it is processed by Social Security in 2-4 weeks and sent to Disability Determination Services. The Disability Determination Services is where the application resides for the majority of the process. The case is assigned to an adjudicator within 1-2 months of being filed and the adjudicator is in charge of the case until a decision is eventually made.
                The first step an adjudicator takes is to request copies of all medical records from the sources listed in the initial application. To obtain further information adjudicators typically send out additional forms referred to as ADL’s, or activities of daily living. The ADL’s provide Social Security with an idea of how the disability affects the claimant’s life on a daily basis.  Once all medical records have been received by the adjudicator as well as the ADL’s, the adjudicator reviews all the evidence that has been obtained. This is usually the halfway point of the initial application process.
                If there is sufficient evidence provided in the records to make a determination about whether the claimant is fully disabled, the adjudicator will make a decision and send out the notice. However, if the claimant’s medical records are not detailed enough, the adjudicator will request that a Consultative Exam, or a doctor’s appointment with a doctor designated by Social Security. These exams are generally brief and designed to provide only the missing information the adjudicator needs. Once the exam has been scheduled and completed, the doctor will send the adjudicator the written report.
The final medical review will then take place with all the necessary evidence. The final medical review is completed by another doctor to make an objective decision. This doctor is to decide if the claimant will be able to return to any type of work. This final review is the last step and typically occurs between the 4th and 6th month after the application. Once a decision is made, the case is sent back to Social Security and within 2 weeks a decision notice is sent out. This is either a favorable decision or a denial, which can be appealed and taken to the next level.

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