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How does the Social Security Administration apply Social Security Disability Laws to determine if I am disabled?

By   /  March 3, 2016  /  388 Comments

Learn how Social Security Disability laws apply to your claim and how the disability evaluation process will be used to decide if you are disabled.

social-security-disability-lawsThe Five-Step Disability Evaluation

To determine whether you are eligible for benefits, your claim will undergo a series of five reviews in a specific order set by Social Security Laws.

Step One: Evaluating Your Insured Status and Your Work Activity

First, before your claim is evaluated medically, your local Social Security office will review your Social Security Earnings Record to determine whether you have enough work credits to be insured for Social Security Disability. For more information about how to become insured, please visit our video, “How Much Social Security-covered Work Do I Need to Receive Social Security Disability Insurance Benefits?”

If you are insured, Social Security will review any work you have done after the disability date you are claiming. Part of Social Security’s definition of disability is “the inability to engage in any substantial gainful activity,” so the work you have performed after your claimed date of disability will be reviewed to determine if it is substantial.

Disability Determination Services

If you have not worked since the date you are claiming disability or your work is not “substantial” or it was an unsuccessful work attempt, your claim will be sent to a state agency, called Disability Determination Services. This agency, DDS for short, has been contracted by Social Security to decide whether you are disabled according to Social Security Disability rules. Please visit our article “What Is Disability According to Social Security Law?” for more information about Social Security’s definition of disability and a discussion of substantial gainful work and “How Can I Tell If I Will Meet Social Security Disability Requirements?” for a discussion of unsuccessful work attempts.

Medical Documentation for Your Disability Claim

To apply Social Security’s definition of disability to your claim, DDS needs documentation of your physical or mental impairments. This documentation must come from medical professionals defined by Social Security as acceptable medical sources. Social Security regulations say that you are responsible for providing medical evidence to support your claim; however, DDS may help you by requesting medical records from your doctors, hospitals, clinics, and pharmacies. They will also request a statement from your physicians. Because you are ultimately responsible for submitting the necessary information and because your treating physicians’ statements are considered to be very important in the claim evaluation process, you should let all your doctors know that a report will be requested and what it will ask for.

Following Up and Getting Help

It’s also a good idea to contact the Disability Determining Services periodically to see what information, if any, they may still be waiting for. This will allow you to follow up with the medical providers to get the requested information released. Here’s where having a lawyer who is experienced in Social Security is a real asset! He or she can contact your doctor to clarify Social Security’s questions. This in turn will help the doctor prepare a report that fully addresses the points to be evaluated by DDS. Having an attorney assume these tasks will also relieve you of some of the burden of pursuing your claim. When you are not feeling well, this can be very desirable.

Additional Disability Proofs

Sometimes statements from care providers, employers, social workers, and other health care providers such as chiropractors and naturopaths can add important information about your limitations. Even statements from relatives, neighbors, and friends may be helpful. You or your attorney will need to gather these statements and submit them to DDS because typically DDS will not request them. Our article “Would It Help My Disability Claim to Get a Statement from My Employer about My Problems at Work?” talks more about employer statements.

What to Do If You Are Asked to Attend an Examination

If DDS does not receive enough information to determine the extent of your limitations, they will ask you to attend a medical or psychological evaluation. This is called a Consultative Examination. The examination will be at no cost to you. If your treating physician is qualified and willing, he may perform the examination; otherwise, you will see a doctor you haven’t seen before. The examination is for evaluation only, not for treatment. If you are asked to go to a Consultative Exam, it is extremely important that you attend and cooperate fully. If you do not, it is likely your claim will be denied.

Once the Disability Determining Services has received all the medical information that is needed or that is available, they will take your claim through the remaining four steps to decide whether you are disabled.

Step Two: Is Your Medical or Psychological Condition Severe?

The first step is to evaluate whether your condition is severe. By this, Social Security means that you are significantly limited in your ability to do basic work activities. If they determine that your condition is not severe, your claim will be denied.

Step Three: Does Your Condition Meet the Social Security Disability Listings?

If DDS finds that your condition is severe, they will move on to the third step, which is to evaluate whether your condition is so severe that it is included in Social Security’s List of Impairments. It’s important to note that to be placed on the List of Impairments an illness or injury must be accompanied by certain signs or symptoms. If your condition meets or is comparable to a listing, DDS will determine that you are disabled. See our article “Is there a Social Security Disability list of impairments, that is, a list of illnesses and injuries, that Social Security considers disabling?”

Step Four: Are You Disabled from Work You Have Done in the Past?

If your condition does not meet a listing, the evaluation will move to the fourth step, which is to evaluate whether you can perform work that you have done in the past. In this step, DDS reviews your limitations and capacities and compares them to the physical and mental requirements of your former work. If you cannot perform work you have done in the past, the evaluation will move to Step 5.

Step Five: Can You Work in a New Occupation

If you cannot do work you have done in the past then your claim will be evaluated to determine whether you are able to perform work that you have not done before. In this step, DDS looks at your limitations and capacities, your education and training, and your work history to see if you have skills and knowledge that can be transferred to other work you are physically and mentally able to perform.

How this step is applied depends in part on your age. If you are age fifty or older more consideration is given to your age and education in answering the question of whether you have the ability to begin a new occupation. How much over age fifty you are and how much education you have, especially advanced education, play into that analysis.

In this step, regardless of age, if it is determined that you cannot perform work that is new to you, you will be found disabled and your claim will be approved.

How does the Social Security Administration apply Social Security Disability Laws to determine if I am disabled?
3 (60%) 2 votes

  • missinglink

    Hello, my son is 22 years old and has been receiving SSI since he was 14 due to autism, anxiety and depression. When he turned 19 we received a letter from Social Security that he no longer qualified, I appealed and lost because although he has limitations they feel he can work in custodial or recycling services. I appealed again. My son has never worked, he cant but did graduate HS and is attending a community college via the disabled students department as he is high function yet struggles at school and executive functions. Even minuscule tasks such as cleaning his room prove to be overwhelming.

    Now have an upcoming hearing before an administrative judge. I did try to secure an attorney but due to the short notice (5 weeks) he was unable to represent my son. I asked the judge for an extension in order to secure representation but it was denied. One thing the attorney did find out is that the Social Security does not have any medical information after 4/2015. I sent information on 2 dates after 4/15 but it seems it was not added to his case. As of 3 years ago he receives additional treatment for bipolar as well as psychosis. His treating psychiatrist and psychologist have wrote letters advising that he cannot work and I have faxed them in to the judge but do not know if they will be considered, I am worried and do not know what to expect or what else I can do. I was told to attend the hearing and ask for an extension, any guidance is greatly welcome.

    • Dear Missinglink,

      The additional documentation that you submitted will be considered. Just in case, be prepared to present your son’s case in court because you may be denied an extension given that your request for an extension has already been denied once.

      Testify about your son’s inability to clean his room as an example of why he cannot work as a custodian or in recycling center. If the vocational expert identifies jobs, ask whether he could do the jobs with the limitations he has. Ask this question for each of his limitations, such as needing someone to keep him on task (this apparently is needed in your example of his difficulty cleaning his room.)

      Sincerely,
      Kay

  • Dear Sabrena,

    I can predict how long it will take for you to get a decision; initial claim decisions typically take from two to five months.

    Sincerely,
    Kay

  • Dear Mefrsd,

    The same regulations apply to new claims and continuing disability reviews–the person must be disabled as defined by Social Security law. Treating physician’s opinions are supposed to be given weight if they are supported by testing or clinical findings.

    Sincerely,
    Kay

  • Dear Vanessa,

    Social Security and the Veterans Administration have different definitions of disability. However, if your husband believes that he cannot work in other occupations, he can appeal the denial. If he decides to due so, I suggest that he request a copy of his claim file to see the exact reasons for the denial and the evidence it was based on.

    It could also be helpful to go over your claim with an experienced Social Security attorney to determine whether and how to appeal. When you hire a Social Security attorney, you do not have to pay any legal fees up front and you will pay attorney fees only if you are approved for benefits. Social Security law sets the amount the attorney can charge and the Social Security Administration pays the attorney directly from your back pay.

    Sincerely,
    Kay

  • Dear Sabrena,

    Please see my response to your first post. Because your claim has been to quality assurance, I would expect your to get a decision within a month of the consultative examination report being received. Again, be sure that the DDS has the test report that diagnosed the tumor and that you describe the related symptoms.

    Sincerely,
    Kay

  • Dear Sabrena,

    Quality assurance(QA) reviews can result in additional investigation being done because the QA review determined that the initial decision was not adequately documented. Be sure the DDS knows about the pituitary tumor and any symptoms related to it.

    Sincerely,
    Kay

  • Dear Scorpion,

    Apparently, the examiner felt that he or she had enough information about your medical condition to make a decision. Be sure to submit everything you can about your current condition for the current appeal, especially information that was not available when your prior claim was last denied.

    Sincerely,
    Kay

  • Dear Leslie,

    Because you didn’t provide the names and contact information of your therapist and psychiatrist when you filed your claim and they came to light during the consultative examination, the claims examiner is doing the routine work of getting information from your mental health providers so it can be considered in making a decision on your claim.

    Sincerely,
    Kay

  • Dear Vanessa,

    The wording, “working to process your benefit application” may be an indication of being found disabled.

    Sincerely,
    Kay

  • Dear Nicole,

    Typically quality assurance (QA) reviews take less than a month.

    Sincerely,
    Kay

  • Dear Jon,

    If you feel you really cannot work, I suggest that you request a copy of your claim file so that you can see the exact reasons for the denial and the evidence the decision was based on. Then discuss your claim and the information in the claim file with an experienced Social Security attorney to see whether you have the basis for an appeal.

    When you hire a Social Security attorney, you do not have to pay any legal fees up front and you will pay attorney fees only if you are approved for benefits. Social Security law sets the amount the attorney can charge and the Social Security Administration pays the attorney directly from your back pay.

    Sincerely,
    Kay

  • Dear Timothy,

    The comment “light at the end of the tunnel” may be a way of saying that an approval decision had been made and that if quality assurance upholds the decision, your claim will be approved. However, there is not guarantee that is the case; the representative might just have been saying that you would have the decision, whatever it is, soon.

    Sincerely,
    Kay

  • Dear Jodi,

    As you describe your condition, I expect you to be medically approved for benefits.

    Sincerely,
    Kay

  • Dear Gregory,

    Street knowledge is often wrong and in this case it is wrong. Not all claims are denied on first application; many are approved. Additionally, all claims are investigated; none are automatically denied. The call for information indicates that your claim is actively being reviewed and investigated, which is good because it means your claim is moving toward a decision.

    Sincerely,
    Kay

  • Dear Veronica,

    Physicians review claims that are approvals and denials, so the information your received is not an indication of what the decision is.

    Sincerely,
    Kay

  • You are welcome, Vanessa.

  • Dear Vanessa,

    Perhaps the online status has not been updated. Another possibility is that the DDS has asked the local office to get some non-medical information from your husband such as work history. I suggest that your husband call the local office to find out the status of his claim and whether he needs to submit anything.

    Sincerely,
    Kay

  • Dear Reginals,

    Reports are that the language “application for benefits” is a hint that the claim has been approved. Keep watching the site because at least in some cases, the decision is posted in another status update.

    Sincerely,
    Kay

    • reginald bunch

      THANK YOU

  • Dear Tammy,

    By all means call the Disability Determination Services (DDS) and give the examiner the names and contact information for the new medical providers and also tell him or her that you are now using a walker prescribed the physical therapist. Ask whether they will get the records or want you to. Then follow up with a letter stating the same information and keep a copy for your records.

    Sincerely,
    Kay

    • Tammy

      Thank you Kay, I appreciate the good advice

  • Dear Vanessa,

    Your husband’s claim could be either approved or denied. Keep watching the online status reports and the mailbox.

    Sincerely,
    Kay

  • You are welcome, Vanessa.

  • Dear Vanessa,

    You may be considered disabled due to your migraine headaches. I suggest that you file a claim. Be specific about the character of the migraines and how long they last and how medication helps or does not help.

    Sincerely,
    Kay

  • Dear Sherry,

    All your medical conditions are considered in determining whether or not you are disabled. One set of limitations from one condition could keep you from working in certain occupations and limitations from a different condition could prohibit work in other different occupations. Accordingly, it is important to submit information about all your conditions. You can tell the examiner about the EMG and the diagnosis and the splints and give an estimate of how long it will take you to get and submit the records.

    Because the prior decision was final and closed when appeals were exhausted, it is unlikely that evidence from a prior claim will be sought. If you want it considered as medical history, you will need to submit it.

    Sincerely,
    Kay

  • Dear Sherry,

    It can be difficult to prove disability caused by several conditions in combination when none is necessarily severe enough by itself. The fact that you are over fifty will change the review process in terms of new occupations you might be able to perform, so you have a better chance of approval than when you initially applied. (Although the judge did not approve you with a later, after fifty, onset date.) You and your physicians need to state what specific functional limitations you have and the condition that causes each limitation. The doctors also need to reference test results and/or clinical findings that support the limitations.

    Sincerely,
    Kay

  • Dear Jerr,

    I would say that your claim has been medically approved and the local office will be asking for some non-medical information to complete review of the non-medical eligibility factors.

    Sincerely,
    Kay

  • H Clark

    Kay, just something that I wanted to add about my approval that surprised me. I had originally filed the first time in 2013 and was denied. Went all the way to the Appeals Council. So, after receiving my letter informing me of the denial (we had decided not to file a civil action) I immediately re-filed 8/8/16. I was naturally assuming that when I got the call informing me of my approval, I was still going to have to wait another month or two for the 5 month waiting period. However, I was pleasantly surprised when SSA had taken it upon themselves to establish my EOD back to the date of my 55th birthday in March. on my birthday this past March. Undoubtedly, I would assume I was granted a medical-vocational ruling.

    • Dear H.,

      You are right that the guidelines for determining disability change at age fifty-five.

      Sincerely,
      Kay

  • Dear Jessi,

    Your boyfriend needs to attend any exam that is schedules for him. I suggest that he call the claims examiner to let him or her know the dates that he will be in the middle of a move so that the appointment can be made before the move or his claim file can be transferred to his new state and the appointment set up there after he has moved.

    It could be very helpful for his doctor, especially his specialist, to write a letter listing his diagnoses, the symptoms and limitations stemming from the diagnoses and the test results and/or clinical findings that support the diagnoses and limitations.

    If he is denied, then, yes, I’d recommend that he hire an experienced Social Security attorney. When he hires a Social Security attorney, he does not have to pay any legal fees up front and he will pay attorney fees only if he is approved for benefits. Social Security law sets the amount the attorney can charge and the Social Security Administration pays the attorney directly from his back pay.

    Sincerely,
    Kay

  • Dear Meghan,

    A medical decision was made on your claim and then it was randomly chosen for a quality assurance (QA) review. If the decision is upheld by the QA department and it was an approval, the claim will move to having a non-medical final review and payment authorized. It the decision was a denial, you will receive a denial letter. If QA finds more investigation is needed before a decision can be finalized, it will be returned to the decision maker for more investigation and/or documentation.

    Sincerely,
    Kay

  • Dear Michelle,

    Apparently your claim was randomly selected for a quality assurance (QA) review. The review can affirm the decision, overturn it, or return it to the examiner for more investigation. The review should not take more than two or three weeks. Because you are claiming disability for multiple conditions and because your disability caused by cancer treatment has to disabled you for twelve months or more, I am not able to predict an approval or denial.

    If you get a duration denial saying you are disabled but won’t be disabled twelve months total and at that time you are experiencing disabling side effects from treatment so that you might be disabled for twelve months, wait until close to the end of your appeals period and file an appeal submitting evidence that you are still disabled at that point in time.

    Sincerely,
    Kay

  • OLadyNDaShoe Teague-Mo

    My son got denied even though he has ADHD and Conduct Disorder and is now also exhibiting signs of depression. He is angry and volatile when he has to go to school. He hides in the house to avoid school, before that he got rid of his school badge so he can go to In School Suspension everyday. How can they put my child on medication and make me return to bring him for services but turn around and deny him disability. Before the dodging school he was sleeping in most of his classes.

    • Dear Ol Lady,

      I suggest that request a copy of your son’s claim file so that you can see the exact reasons for the denial and the evidence it was base on. Then eithe appeal the denial or file a new claim if you are out of the appeals period. If you can still appeal, hiring an attorney will help you address whatever errors or omissions exist in your son’s claim.

      When you hire a Social Security attorney, you do not have to pay any legal fees up front and you will pay attorney fees only if your son is approved for benefits. Social Security law sets the amount the attorney can charge and the Social Security Administration pays the attorney directly from the back pay due your son.

      Sincerely,
      Kay

  • Karen

    Hi – I applied over a year ago and was denied. Got a lawyer and started appeal in 9/2016 – just went for a mental exam at their request. At the end of the test the examiner said “I really hope you can find someone to talk with and get some counseling, I really think it would benefit you to get some inner peace.” He seemed genuine in wanting me to find peace and also that my depression and anxiety were real due to my disability. I have constant double vision 24/7 due to numerous surgeries. I have depression and anxiety due to this. Was he really supposed to say that? Do you think that is a good sign that I might be approved? That this isn’t a vision disability but a mental disability due to vision issue. Thanks

    • Kay Derochie

      Dear Karen,

      It seems as if you could be approved based on your vision impairment as you describe it. The mental health examination could have been scheduled because either you listed the depression and anxiety on your application or the diagnoses appeared in the chart notes.

      Sincerely,
      Kay

  • Ashley B

    Hi Kay The Dds Is Sending My Son To A Speech Evaluation, Although he has been going to his own Therapists, For Speech, for 9 months any Reason Why They Couldn’t make a Decision off Of His Current record’s date all the way 9 months Back?? And Also When he Goes to This CE for The Speech Evaluation Will they Let me sit in while they perform the Evaluation? And Oh My Son is 21 months old, And he Doesn’t say any words And he has Never Said any and he’s been in Therapy for 9 months and hasn’t learned any so far, and also he goes to therapy for feeding and occupational therapy!!!

    • Kay Derochie

      Dear Ashley,

      I do not know what information is desired and is missing in your child’s medical records causing the need for a consultative examination. I would think that as young as your son is that it is likely that you will be allowed to be present for the evaluation

      Sincerely,
      Kay

      • Ashley b

        Ty you so much kay!!

        • Kay Derochie

          You are welcome, Ashley.

          • Ashley B

            Hi Kay , My son went to the Speech evaluation yesterday 12/5/16 and the SLP said that he is 6 months behind, and She recommend me to go to a program called early steps, she tried making him repeat after her but it was impossible because he can’t say one word, and also she tried making him build blocks and he was unsucceful, she said he is very delayed with his speech although he do have a little communication skills, he should be talking and saying at least 50-100 words and forming 2 word or 3 word sentences, What are my chances of getting approved? And to be eligible for SSI for Speech delay how delayed do social security expect a 22 month old to be? He never said 1 word, and we’ve been in therapy 9 months and he still doesn’t say a word…..

            • Ashley B

              And I forgot to add the DDS sent him to one of their doctors for the Speech Evaluation that I’m Speaking about above! Thank You Kay!!!!

            • Kay Derochie

              Dear Ashley,

              I don’t think there is an exact formula for how delayed your child has to be in speech to be approved; however, six months in the life of a twenty-two-month-old child is a considerable delay and there is a possibility of approval.

              Sincerely,
              Kay

  • Marie

    I received a CDR form after two years instead of the three years. I was reading on one SS blog that an early review can be triggered if a third party said you weren’t following medical plans or if doctor reported that you improved. I don’t know how any could say I’ve improved, especially since I was recently diagnosed with even more health problems.

    I did though have a problem with one doctor. He figured out I was homeless somehow and threw me out of the office without doing much except ask couple of questions. Then before I could leave the cops were pulling up behind me saying someone had called in that I was there refusing to leave after being asked to leave. I was just in the parking lot and I was leaving. Cop let me leave instead of being arrested. I was so shook up from it I got sick on my stomach and my PTSD was triggered. He is on the top of my suspect list.

    I need my medication to live and I am terrified I will be cut off and have to live in the streets forever. No employer will ever hire me. Every employer in the more recent working years fired me after seeing how messed up I am medically. I usually didn’t last over few days.

    My primary care provider sent me to a new specialist and she found problems that probably been there for years that the other one didn’t notice. The one that sent me away never did a test on me whole time I was there.

    I’m really scared. I turned in the papers. I’m so stressed out I’m sick on my stomach. I don’t have much now and I might lose everything. I always wanted to be able to work, but I was never able to hold down a job no matter how hard I tried. I get sick much of the time. If they cut me off I’m going to die without my medication. My meds cost nearly $2k a month. I could never afford them. Never.

    • Kay Derochie

      Dear Marie,

      It really does not matter whether the early review is due to someone reporting doubts about your disability or who that might be. You just need to provide enough information to show you are still disabled. If you provided information about your current health and limitations including the new problem and that evidence shows that you are still disabled, your benefits will continue. You might also let them know that the one doctor would not be a reliable source regarding your condition because he saw you only for a few minutes during which he asked you a couple questions and then asked you to leave when he found out your were homeless.

      Sincerely,
      Kay

      • Marie

        I did include about the neurologist that called the cops on me. I also talked about how he didn’t do anything for me all the years I’d seen him and the new neurologist has done more tests in a few weeks than he did in four years.

        I also haven’t been able to go to therapy. In this area the only counselors that will take my medicaid insurance are some social workers at this one counseling center. Last year another therapist sent me away again because I wasn’t showing enough improvement on some circle numbers sheet I was expected to fill out each session. Part of my disability is PTSD. And none of these therapists have ever even understood what I was going through. They acted like when I’d be triggered and had an anxiety attack that I was just having a bad attitude and that I needed to just get over what happened to me and cheer up. I haven’t found a therapist to see me since the last one sent me away.

  • Janette

    I have recently applied for disability due to neck and back problems as well as depression. My pain clinic wants to perform a radiofrequency neurotomy on L 2-5. How could this affect my disability?

    • Kay Derochie

      Dear Janette,

      If the procedure improves your condition to the point that you can work, then the procedure could affect your eligibility for disability benefits.

      Sincerely,
      Kay

  • Kris

    Hi, I was in disability for a long time then I tried getting off it and having a regular full time job. I tried a few full time jobs and failed miserably at all of them. I starting relapsing from bipolar disorder and my meds weren’t working for me anymore. Now I’m back on temporary disability until they make a decision if I’m still disabled or not. Problem is they keep sending the same questionnaire for me to fill out over and over. Well the first one asked about doctors appointments and illnesses. And the last 2 seemed very similar in how I handle day to day living. Why are they asking the same thing over and over? To date so far things are worse each time they send a new questionnaire out. My mental state is worse than before. I don’t know what to make of it.

    • Kay Derochie

      Dear Kris,

      Look closely at the two questionnaires about your daily activities, especially at the top. It is possible that one is supposed to be completed by someone who knows you well and knows about your activities of daily living. Although it can be tedious, be sure to complete each form to the best of your ability.

      Sincerely,
      Kay

      • Kris

        Thank you for the reply. I read the instructions on all the forms. Though the last one was a little confusing on its wording. However it said basically only I should find out the form not a doctor or anyone else. It was just very stressful after answering the questions. It really showed how downhill I’ve gone. Thanks again.

        • Kay Derochie

          You are welcome, Kris.

  • Dawn

    I applied for ssi last month and the office manager sent me an email say I g she got my medical record and she would call on the 16th and then the case worker she assigned to my case would call 2 wks later is this a good sign with a caseworker already assigned to my case with an appointment made with them I have inflammatory arthritis and fibromyalgia and ibs

    • Kay Derochie

      Dear Dawn,

      It is good that your claim is being actively worked on; it is not a sign of what the decision might be.

      Sincerely,
      Kay

  • Jo

    Got a call from the determine office asking for my family doc info and asking about what doc prescribe my pain meds

    • Kay Derochie

      Dear Jo,

      If you have a question, please complete your post, so I can respond.

      Sincerely,
      Kay

  • rika

    I applied for disability in june 2016 i recieved a pain and daily activites questionnaire on sept.27 2016 is this a good sign

    • Kay Derochie

      Dear Rika,

      Your were sent the questionnaire to gather information. It is not a sign of approval or denial.

      Sincerely,
      Kay

  • Michelle WALLACE

    I filed in July 2016. Fibromyalgia, migraines, arthritis, scoliosis, etc.. well it first went to local office. Then sent to the main office and now they say they have made a decision already and that my file went out of state and to look for a letter from ss even if it’s from out of state to read it. I sent medical records to them alreadt. So my question is with less than 2 months with file is that good or bad? Also after being in 2 offices and a decision has been made why is it being sent out of state? Thank you for your time.

    • Kay Derochie

      Dear Michelle,

      Your claim may have been denied with the claim file being sent for storage; however, you can’t know for sure until you get the decision letter.

      Sincerely,
      Kay

  • Benjamin Smith

    Hello,

    I need some help for clarification. About two weeks ago my local SSA office claim rep called me asking me for my last dates of work. I told him June 14th. He said that DDS was asking for it. I asked him why he needed it and stated it was for my onset date. Yesterday I called my DDS office and spoke with my examiner and she had started that it was sent over for review after she worked on the case. I suffer bipolar disorder and when we sent over the function report and the work history we sent over all 42 jobs I’ve has since I waS 18 now 23. Is this a sign I may be approved? Live in MN if that helps. Thanks

    • Kay Derochie

      Dear Benjamin,

      The inquiry about work dates as related to disability onset seems to be an indication that your claim will be approved, but you can’t be sure until you get the decision.

      Sincerely,
      Kay

  • Theresa Martinez

    I have a question please. I am in the process if filling for disability as I have a lot of back problems, have had surgery on my cervical which I have a plate and screws there. Also have some disc issues in my thoracic and lumbar spine, depression, neuropathy , arthritis in my toes, recently the Dr sent me for xray of lumbar and my knees to which shows the beginning of arthritis in both places, I’ve went from a full time job to part time to only caring for my elderly mother which I get paid for 20 hrs a week. Will those 20 hrs get me denied?

    • Kay Derochie

      Dear Theresa,

      If your gross earnings are less than $1,130, the work will probably not adversely affect your claim.

      Sincerely,
      Kay

  • Marilee

    Hi:
    I have suffered from depression/anxiety since I was a teenager. I have been on a plethora of meds and nothing really seems to help. I also have been to counseling on and off, which I don’t believe in anymore. Anyway, I am now 49 years old and I have had over 33 jobs in my lifetime. I have been fired from over half of these jobs. I signed up with Vocational Rehabilitation last August and they have my case on hold until I can get the proper counseling and medication. They have me deemed most severely depressed with severe anxiety. Also, they have documented on their paperwork that I do not do well with people and/or my co-workers. Can their documentation on my condition play a significant role on me getting approved for SSDI?

    I appreciate your time,
    Marilee

    • Kay Derochie

      Dear Marilee,

      Yes, the Department of Vocational Rehabilitation’s evaluation should support that you are unable to work now. I suggest you file not only Supplemental Security Income (SSI) claim. In addition, if some of your sporadic work has been in the last ten years, also file a Social Security Disability (SSD) claim. For the SSD claim list as a date of disability onset the day after the last time you were employed for more than six months earning at least the amount shown in the list below. Also, for your claim, be sure to list every job you can remember and the reason you left. Be specific as to the reason you were fired (specific behavioral problems at work, excess absenteeism, etc.) If you are denied, appeal with the assistance of an experienced Social Security attorney.

      Substantial Gainful Activity Benchmarks
      In calendar year 2016, $1,130
      In calendar year 2015, $1,090
      In calendar year 2014, $1,070
      In calendar year 2013, $1,040
      In calendar year 2012, $1,010
      In calendar year 2011, $1,000
      In calendar year 2010, $1,000
      In calendar year 2009, $980
      In calendar year 2008, $940
      In calendar year 2007, $900
      In calendar year 2006, $860
      In calendar year 2005, $830

      Sincerely,
      Kay

  • Merhawit

    Hi my name is Merhawit Teklay I live in Ethiopia i need help i disabled person pleas pleas i treatment.

    • Kay Derochie

      Dear Merhawit,

      If you have worked and paid U.S. Social Security taxes and want to file a disability claim, you can do so through an American Embassy in your country.

      Sincerely,
      Kay

  • ShaQuwana Farrow

    Hello, I was wondering if you could help answer some questions.

    I applied for ssdi/ssi on may 23rd. I have sarcoidosis, bipolar and anxiety. I was sen to a medical exam but i was told they medical would not give much about my sarcoidosis anywhere. as there is no cure. only treatment for flare ups and even the treatment is not that good. I am also bipolar and have been hospitalized due to a suicide attempt. I went to the mental consultation august 9th. about a week later my husband was called to answer questions about a function report. I was wondering about how much longer would it usually take for me to get a answer and what are my approval odds.

    • Kay Derochie

      Dear ShaQuwana,

      It could easily be another month before you get a decision. I can’t say for sure, but I would say that there is a reasonable possibility that you could be approved.

      Sincerely,
      Kay

  • Charisel

    Hi,

    Hopefully this is a quick question for you. I’m currently on SSDI for a mix of reasons but mostly for Meniere’s Disease, Vertigo and Anxiety. My case is being reviewed and I have a doctor that will help advocate for me as Meniere’s is one of those “sometimes fine and sometimes not” kind of things. SO I can drive sometimes and sometimes can’t etc. Anyways, she works a big hospital and asked if I could get the paperwork directly to her as she rarely sees it the way it is routed through her organization. Is this something I can get from the Social Security offices or call and give them her direct info, to make sure she gets a copy of whatever they send?

    THank you in advance for your assistance.
    Charisel

    • Kay Derochie

      Dear Charisel,

      I suggest asking the doctor whether there is any mailing address that would get the paperwork directly to her. If so, call the Disability Determination Services (DDS) and ask to correct the contact information for that doctor. If that is not possible, then talk with the DDS examiner and ask her how it can be handled. If that turns out not to be effective, then ask the doctor to write up a statement regarding your diagnoses, how long you have had the conditions and what your limitations and restrictions are. Have her indicate how often you have spells from the Meniere’s and vertigo that incapacitate you and how long they last. If the same doctor is treating you for anxiety, she can then delineate any limitations you have related to it. If you have a psychiatrist or therapist treating you for the anxiety, have the specialist make the statement for you.

      Sincerely,
      Kay

  • Amanda Case

    I got a call asking for more information about my case after seeing the ssa psychologist, I was diagnosed with bipolar disorder at age 9 and I’m currently on meds for it and migraines, I wont be able to call back till Monday to see what info they needed, I was just wondering what info they might want so I can be prepared and is this a good sign?

    • Kay Derochie

      Dear Amanda,

      Not knowing which office the call came from, I can’t know what is being requested. If it was from the local office, it could be information needed because you were approved. If it came from the Disability Determination Services, then the claim would still be under review and the call might to be collect more medical or work-history information.

      Sincerely,
      Kay

  • The disability examiner said she finished reviewing my case and I should have a decision in couple of weeks unless he needs something else from me..what does that mean.how can you be finished and still need more information..possibly.

    • Kay Derochie

      Dear Shon,

      My guess is that the examiner is sending your claim for review by a physician after completing her own review and decision recommendation. If the physician sees that something is missing that is needed for a decision, you could be asked for additional information.

      Sincerely,
      Kay

      • Thanks for clearing that up for me.

        • Kay Derochie

          You are welcome, Shon.

  • kit

    Hi Kay,

    thank you so much for all the time and care you give to answering questions here.

    I am wondering if you would have any ideas about this:

    I have read in the social security policies that claims examiners have the option to fill out adult function forms over the phone or to send them in the mail.

    Seems like most people get them in a the mail, but I have met a few folks who get them by phone.

    I am wondering what your thoughts are on this:

    Do you think someone would be allowed to request a form by mail?

    How would they make the request? Would they have to make this request in writing ahead of time?

    Would they need to show that it was because of their symptoms or disability that made oral interviews too difficult?

    Or could they just wait and see if they get notified of a phone interview? And then if it happens, request to be sent the questions in writing instead?

    Or are they obligated to do a phone interview and cannot get out of it once the claims examiner has requested it?

    • Kay Derochie

      Dear Kit,

      Adult function forms are not always requested. If you think completing one would help your claim, you can ask to have one mailed to you. To do this, you need to contact the claims examiner at the Disability Determination Services (DDS) who is handling your claim. If you have been requested to do a phone interview, you can request having the form mailed to you, but it would be helpful to have a reason. For example, you have trouble communicating by phone or you can’t think quickly–whatever applies to you.

      Sincerely,
      Kay

      • kit

        this was super helpful. thank you so much.

        • Kay Derochie

          You are welcome, Kit.

    • brady hatcher

      Hi my name is brandy. I just got a cdr
      After 9 yrs of being disabeled. I foiled it out last month and the examiner mailed me paperwork on my seizures. He said he had enough information on my psychiatric. I go to a day program for my mental illness a couple of days a week. What’s my chances of being approved as I am very stressed.

      • Kay Derochie

        Dear Brady,

        I think your eligibility will continue based on your mental illness being significant enough to require a day program. If benefits are terminated, appeal right away.

        Sincerely,
        Kay

    • Kim

      I would like to know will I be approved if my therapist and psychohistory be filled out

      • Kay Derochie

        Dear Kim,

        Your therapist completing a statement will be useful to your claim. Whether or not you are approved will depend on how significantly your mental health condition affects your ability to work.

        Sincerely,
        Kay

        • Kim

          I have been seeing a therapist for a year and half or 2 years now and a have anxiety depression ocd and asthma I take medicine for all never really worked and have a 9 grade education and suffer from domestic violence other childhood abuse and its noted on my records can this help me win my case it’s also hard for me to sleep without my meds and I have my high and low days

          • Kay Derochie

            Dear Kim,

            I do not know whether your conditions are severe enough for you to be disabled accordingly to Social Security law, which also applies to Supplemental Security Income (SSI) claims. I suggest that you file a claim with the Social Security Administration to get a determination.

            Sincerely,
            Kay

    • Jaclyn

      Hi, I was approved for disability in late Dec 2012 for Multiple Sclerosis which is a progressive debilitating disease with no cure. I received a CDR last week and was just wondering if this is normal for a person with a disease that’s not curable? I filled out a mailer last month and checked the boxes that I still don’t work and my disease has worsened. I’m very confused and wondering if I will have to go through these reviews for the rest of my life as I’m only 36 yrs old. I have horrible hand/finger spasms and the paperwork is several pages a bit much. Thanks in advance

      • Kay Derochie

        Dear Jaclyn,

        You may be asked to provide information for a continuing disability review (CDR) again, but the frequency may be less in the future.

        Sincerely,
        Kay

  • Juliana

    My mother was approved for ssi on feb 2014 in ohio and in dec 2015 she moved from ohio to arkansas. We did notified then about the move and got a letter in feb 2016 saying her benefits would be the same . End of march she got a letter saying she was schedule for an interview to get her case reviewed. After the interview they said she is not eligible because she is not a citizen , only a permanent resident and that ohio made a mistake when have her the benefits ! They will stop her benefits! My mothers has reumathoid artriryrs , lupus and Renault and is in a lot of pain all the time! What can she do? Can she apeal? Does she need to become a citizen and apply again ? Please help ! Thank you

    • Kay Derochie

      Dear Juliana,

      Some classes of aliens who are not permanent residents can receive SSI. The regulations are complex and detailed. You can get a general overview at the following link to see whether your mother falls into one of the eligible classes. See number 2 in this link. https://secure.ssa.gov/apps10/poms.nsf/lnx/0500502100. However, it might be good to get attorney assistance to help review and interpret all the various exceptions to see if your mother has a basis for appeal because there are many provisions and articles that govern alien eligibility for SSI. If she is not eligible now and becomes a citizen or attains permanent residency, she can reapply.

      Sincerely,
      Kay

  • Rana

    my husband had his ssi hearing before the adj judge this week. The VE stated that he couldnt do his past work. Listed jobs that he could do but based on his mental dx that IF he could get a job and IF he could make it thru training he would be fired due to missing 9 to 10 days of work a month due to appointments. Do you think because it basically came down to there were no other jobs at the end that he will be approved?

    • Kay Derochie

      Dear Rana,

      If the judge determines that the medical evidence in file supports that your husband has a medical need for the large number of appointments, it is likely his claim will be approved.

      Sincerely,
      Kay

  • Barbara

    My boyfriend is hard of hearing and suffers from COPD, Pulmonary Hypertension, CHF, and Degenerative Disc Disease. He is at the reconsideration stage. His DDS worker told him that he was medically approved but his case was selected for quality review. After 6 weeks, his case was returned from quality review with a question about his current employment. Apparently, one of his doctor’s checked a box that said he was employed full time rather than part time. He works 8-12 hours a week for minimum wage and has earned roughly a $1000 year to date. DDS sent his file to the local SS office which requested copies of his pay stubs. The local worker seemed annoyed that she even had to complete the paperwork because she thought it was obvious from his file that he had not engaged in SGA but did it anyway. The local office said they returned the file to DDS. Can you tell me what the process is from here? Does the DDS worker have to do anything other than sign off on it again? Will it go back to QR? If so, will they act more quickly this time because they’ve already evaluated and approved the medical part or will they do a complete review again? Any general information on how the QR return process works when it comes to technical issues like SGA would be great.

    • Kay Derochie

      Dear Barbara,

      Based on the information you have provided, your husband’s claim approval will ultimately be upheld. I don’t know whether the DDS has to return the file to QA or not or if it goes back to QA how long it will take.

      Sincerely,
      Kay

  • willis c carter

    Have one claim for disability waiting at federal level. Had surgery filed 2nd claim.sent to see doc and psychologist….she said she was gonna recommend therphy and medication for my depression…. recommend to whom… any help would be appreciated

    • Kay Derochie

      Dear Willis,

      The consulting physician should be making a report only to the Social Security Administration. You might be able to get Social Security to release a copy of the report to your private doctor with your written request and authorization.

      Sincerely,
      Kay

    • Mary

      Hi i file ssdi Dec 7 2015 and call today April 13 2016 to get status of my claim. Thay told me it was in the Determination stage of the process. And i will know bye Jun 7 2016 does this sound like i will be approved? I have COPD since 1987 but i struggle to work all those 30 years . But my condition has worsen over the years. In 2014 my job sent me to a pulmonary specialist to see if i can wear a resperator. im a machine operator at pharmaceutical co. Butt now i can’t breathe any more through the resperator. So i was layoff.

      • Kay Derochie

        Dear Mary,

        I do not know whether you are eligible for disability benefits. It will depend on whether you are disabled from other occupations in addition to the one you have been performing. Your education, work experience, and age are considered in deciding this.

        Sincerely,
        Kay

  • Roger Taylor

    I work in the Trucking Industry in particular Warehousing. I have had a total knee replacement 2 years ago and has added many challenges but I continued to work. Now I have been told from MRI that I have DJD (Degenerative Joint Disease) after taking a fall off my own roof. I am in constant pain, I can’t bend over at the waist, my buttock goes numb if I sit to long, My back flares up if I walk around the house 5 or 6 times. It feels as I’m walking on ice picks that shoot to top of my head. There’s a long list to go with it as well. Would I be a candidate with GED education at 42 Y.O?

    • Roger Taylor

      In addition I have been referred to Neurosurgeon.

      Thank You,
      Scared and Worried

    • Kay Derochie

      Dear Roger,

      Whether or not you are eligible will depend on how well documented your limitations are and whether there are other occupations you can perform within your limitations, such as one in which you could change positions frequently. If you are not now working, I recommend that you file a claim to get a formal determination.

      Sincerely,
      Kay

  • Chelsea

    Will I qualify for disability under my husbands work credit? I have been a stay at home mother for the past 17 yrs. because my youngest son has aspergers. I have advanced rheumatoid arthritis, degenerative disc disease, scoliosis, osteoporosis, and my feet are deforming. Thank you for any info.

    • Kay Derochie

      Dear Chelsea,

      You will not qualify for disability benefits under your husband’s earnings record. When he becomes eligible for benefits, you can apply for wife’s benefits at that time. Depending on your family income and assets, you might qualify for Supplemental Security Income (SSI) disability benefits. You can learn more about SSI in the articles under the SSI on the navigation bar at the top of this web page.

      Sincerely,
      Kay

  • Chelsea

    Hello,

    I went to the hospital the day before yesterday, a second kidney stone in two months, and the registration person said my records said I was disabled? I’m not on any disability benefits and tried to get more information but none was forth coming.

    I’be been diagnosed with depression, anxiety, sleep apnea, PCOS, muscular scoliosis of the lumbar spine, and multiple kidney stones for reasons unknown. I don’t know whether I should apply for social security benefits or not after this information.

    Any suggestions on what I should do next?

    • Kay Derochie

      Dear Chelsea,

      Are you working? If you are and you gross $1,090 or more per month, you would not be considered disabled under Social Security or Supplemental Security Income law. If you are not working or are earning less than $1,090, the question becomes are you able to work? If not, then it would be appropriate to file a disability application.

      The Social Security Administration administers two disability programs–Social Security Disability (SSDI), which requires enough work earnings that have been taxed for Social Security coverage, and Supplemental Security Income (SSI), which requires that your income and assets (and your spouse’s if you are married and living with your spouse) fall below certain limits.

      Sincerely,
      Kay

      • Rodriquez

        Dear Kay may son put in for his ssi and we called the dds office and they told him that his Meds are all in that he should get a letter in the mail 2 to3weeks what do it mean

        • Kay Derochie

          Dear Rodriquez,

          The information you received means that a decision is close to being made.

          Sincerely,
          Kay

          • Rodriquez

            Do we call back in2weeks are just wait it out and wait on the letter

            • Kay Derochie

              Dear Rodriquez,

              I would wait a month before calling again.

              Sincerely,
              Kay

          • Rodriquez

            And is this a good thing I have waiting4 months and now it’s going on5 months I’m scared

            • Kay Derochie

              Dear Rodriquez,

              How long a claim pends is not a sign of what the outcome might be.

              Sincerely,
              Kay

          • Rodriquez

            And vocational rehabilitation called me to come and work in training center is this a good thing do i call them at the ssi office about this before i get my decision

            • Kay Derochie

              Dear Rodriquez,

              I would think that it is a good sign that a vocational assessment resulted in the determination that you are able to work. You do need to report the work training to Social Security. Report what you will be doing, how many hours a week, and what your pay will be, and the name and contact information for the vocational rehabilitation agency or firm and your case worker there.

              Sincerely,
              Kay

        • Rodriquez

          Vocational rehabilitation told him it’s not a real job and they work with people that work with people that’s disable to try to get to work in the real world and try to find them a job out there in the world do we still them at the ssi office about them because they say it’s not a real job

          • Kay Derochie

            Dear Rodriquez,

            Yes, the work does need to be reported even though it is in a sheltered workshop. Depending on how much he earns, the work may have not impact on his claim.

            Sincerely,
            Kay

          • Rodriquez

            He had told the ss office about them the vocational rehabilitation the same day he applied for ss and than they called me back to come and work in the training center do i tell them again

            • Kay Derochie

              Dear Rodriquez,

              There is no need to report again until the claim is approved and then at that time report and provide pay stubs for his earnings.

              Sincerely,
              Kay

          • Rodriquez

            Ok i will thank you

            • Kay Derochie

              You are welcome, Rodriquez.

          • Rodriquez

            With me working for vocational rehabilitation center get me denial for my ssi faster if i work there before i get my decision

            • Kay Derochie

              Dear Rodriquez,

              The type of work you are doing and the amount you will likely earn should not have a negative effect on your claim.

              Sincerely,
              Kay

  • Stephanie Ecklund

    Help please.
    In Oct 2014 I applied for ssi ssdi. After 3 caseworker dieing literally one after another each worker slowly got my case records and medical records. I’m diagnosed in 2003 bipolar 1 schizophrenia liver tum or and ovary cysts. For the past 2 years I have been medicated mental disorders and seeking doctor regularly. In june 2015 still initial case file dds caseworker number 2 told me she was making me and apt with medical examomer for ssdi. She passed away before she could send it finally in September 2015 caseworker 3 got file and make apt with medical examiner. Nov 30 2015 went to it. He sent back report to caseworker and she made decision.december 8 I was not told this decision it was pulled to quality review. December 21 I called back in a waalooa new case worker last one was ill. Wow anyways new case worker said can’t do anything in quality review…. Jan called in and check same details. Now on Jan 19 I called in and was informed that quality review sent back my file to dds and a new caseworker would have to work the file and send it back to quality.? What does all this mean? I feel like I have a curse on me.?

    • Kay Derochie

      Dear Stephanie,

      Apparently, the quality review resulted in a finding that some procedure or some investigation was not done properly, so that the examiner needed to do additional work and then send the claim back to the quality assurance department for additional review. None of this gives an indication of whether the original decision under review was an approval or denial.

      Sincerely,
      Kay

      • Stephanie Ecklund

        The original claim I was told was a denial. The quality review sent it back to dds jan 22 but my caseworker is no longer there and Noone is answering the phone in pennsylvania. I have spoke with the 800 number and local and neither can give me an answer of where it went other than to that office and no other number ti contact anyone. How much longer do I have ti wait. I’m anxiously waiting impatiently

        • Kay Derochie

          Dear Stephanie,

          The 800 number and your local office will not have any more detailed information. Try the Disability Determination Services again. The day you called was a federal holiday.

          Sincerely,
          Kay

          • Stephanie Ecklund

            They ended up sending file back to dds and I got a letter from a disabilty examiner on March 16 2016 who requested update medical records. The last records they had on file was July 2015 before they sent me to mental exam in Nov 2015. Those new records were sent last thursday. So what’s up now.

            • Kay Derochie

              Dear Stephanie,

              I would say that now you wait for them to review the new records and for a decision to be made.

              Sincerely,
              Kay

          • Stephanie Ecklund

            How long will it take for them to rework it. I called last week and sbhe said she recieved the new records on the 18th of march and the 1st of april. So now what?

            • Kay Derochie

              Dear Stephanie,

              It is hard to say; it could be another month or more.

              Sincerely,
              Kay

    • Stephanie M Ecklund

      I finally got denied April 15 2016. Initial denial. Hired attorney to file appeal. When he tried could not cause case was closed 60 days weren’t up yet. Attorney got appeal written faxed in and now waiting game.

      • Kay Derochie

        Thanks for the update, Stephanie.

      • Stephanie M Ecklund

        Filed an appeal June 2016. With attorney waiting in hearing with alj. Got a letter in mail asking if I want a video hearing. What do y’all think.?

        • Kay Derochie

          Dear Stephanie,

          Personally, if I could hang on financially, I would wait and have an in-person hearing. However, every person’s circumstances are different and every claim has different characteristics. Accordingly, I suggest that you discuss with your attorney the pros and cons of a video hearing in your particular situation.

          Sincerely,
          Kay

  • linda

    Hi kayim applying for Ssi for my son who’s is now 8..i was denied I. 2013.. Insufficient evidence beyond adhd.. He has recently been diagnosed w odd.. Adhd.. And some unspecified disturbance disorder.. I reviewed a encrypted DVD.. And had numerous apts since then.. 2 yrs ago. I appealed.. My son also was not in school when they denied him.. Just wondering what the DVD does. And if I get approved. Do I get all the time frame of the process or just the time it may b. Approved?

    • Kay Derochie

      Dear Linda,

      I need more information to respond. What is the contents of the DVD and where did you get it? You said you “appealed two years ago” but it would have been too late to file an appeal on a 2013 denial. (The appeals period for unfavorable decisions is sixty days.) Did you file a new claim in 2015 or was it a second or third appeal?

      Thanks,
      Kay

  • Lucy

    I apply for ssdi in November I will reach 50 years old on March was diagnosed with plantar fasciitis heel spur
    on both foots i had to let go my job that i haf for over 12 years due to the pain on my foots know my podiatry tells me I have a emtrapment nerve on my right foot and he is going to do surgery on January 19 I postpone my surgery due to panic attacks the DDS Called me yesterday to ask me when is my surgery I explained to her why I postponed so it means they are ready on making a decision I wonder how much longer to receive a decision

    • Kay Derochie

      Dear Lucy,

      I can’t say how long it will be till you get a decision; however, it sounds as if you should be adding mental health issues to your claim and submitting any medical records you have of consultation or treatment for your panic attacks.

      Sincerely,
      Kay

  • Laurinda Reis

    Hi, I was just wondering. I aplied for ssi and the social security already sent my case to the disability determination, I called the disability determination case worker that has been assigned to my case to see if she got my papers and she told me ” a decision has been made, i no longer have your case, you are all set” what do you think she meant ? Thank you so much

    • Kay Derochie

      Dear Laurinda,

      Apparently a medical decision has been made. The remark “you are all set” seems to apply a medical approval. If you have not heard from your local office about your SSI claim within ten days of the date you were told your claim was determined, contact your local office to find out whether they need anything from you to start payment.

      Sincerely,
      Kay

      • Laurinda

        Thank you so much Kay for your help.

        • Kay Derochie

          You are welcome, Laurinda.

    • Ambitious

      DEAR KAY
      I WAS WONDERING DO YOU STILL HAVE TO CONTINUE TO TAKE YOUR CHILD TO DOCTOR AFTER BEING APPROVAL FOR SSI BENEFITS?

      • Kay Derochie

        Dear Ambitious,

        You should follow your child’s doctor’s advice on how often the child is seen. At a minimum you need to have the child checked at least once a year to have proof of continuing disability. This is true even if the disability appears to be permanent.

        Sincerely,
        Kay

    • Dawn

      Hi Kay long story short:

      -Applied said/ssi 9/30/15
      -Completed my questionnaire October 2015
      -Dec 2015 DDS adjuster said he has everything
      -end dec 2015 DDS adjuster sent request from hospital because he said “apparently there’s more recent history from this year he wanted from them as well”
      -mental history (pill overdose to be specific/hospitalization) as early as 1994
      -4 documented suicide attempts
      -diagnosed w/anxiety, depression, BPD, OCD, and PTSD in July 2015
      -stopped working August 2014 (fired for disputes with coworkers)
      -work history since 1994
      -SSA stated if approved id be awarded $1300 per month because of how much I’ve paid into doc Sec
      -fired from 17 jobs last 15 years
      -have home therapist
      -taken DBT classes for BPD
      –mentally hospitalized in oct 2015 for attempted suicide
      -1/6/15 DDS stated determination was made but can’t provide to me because it was sent to quality assurance
      -I was not requested to see an SSA or DDS mental health dr for eval
      Is it possible I’ve been denied? Would they have had me see a mental health examiner of their choice (SSA/DDS) into be evaluated if I were going to get approved?
      It hasn’t been even a full4 months and a decision was already reached. Is this possibly because I was likely denied? I also have 3 children and I’m 35 years old.

      • Kay Derochie

        Dear Dawn,

        Social Security will pay for a medical examination only if there is insufficient evidence to make a decision–favorable or unfavorable–without it. Your claim was chosen randomly for a quality assurance review to check to see whether the decision, whatever it is, was arrived at correctly. There is still a possibility that your claim will be approved. If it isn’t, I recommend appealing with the assistance of an experienced Social Security attorney. When you hire a Social Security attorney, you do not have to pay any legal fees up front and you will pay attorney fees only if you are approved for benefits. Social Security law sets the amount your attorney can charge and the Social Security Administration pays the attorney directly from the retroactive award before sending your back pay to you.

        Sincerely,
        Kay

  • Brittany

    Mrs. Kay
    I was told by my son’s school(Easter Seals) that he could possibly be eligible for SSI! I went to apply to the local office October 2! Once the claim went to the dds office I was very quick about getting all the required forms and reports to them! I called earlier this week and they told me a decision has been made and the case was now back at the local office! She also stated to give them about a week and I should hear something. I also called the 1800 number later and was told they set a deadline of the December 29. What does all of this means?

    • Brittany

      Received letter saying to come to local office because they need information from me to see if they can pay me ssi

      • Kay Derochie

        Dear Brittany,

        Please see my reply to your last post.

        Sincerely,
        Kay

    • Kay Derochie

      Dear Brittnay,

      After a medical approval, financial eligibility has to be re-reviewed and payment set up. Sometimes additional financial information is requested. I believe that you were being told that you would either receive payment or a request for more information by December 29.

      Sincerely,
      Kay

      • Brittany

        Thanks for your response! I went in and did the “final interview” and was told I should hear something in 30 days! However, I called and talked to someone the next day and was told it usually process in 2 weeks. Should I expect a payment or letter soon? Tuesday January 5 will be the 2 week mark!

        • Kay Derochie

          Dear Brittany,

          Neither of the estimates is a definite time frame, so there is nothing definite you can count on. Payment usually starts before you receive explanatory award letter.

          Sincerely,
          Kay

  • Lisa Devitt

    I was approved for SSI in December of 2013, I believe as I never received the final favorable letter due to moving. Unfortunately my lawyer did not include one of my disabilities initially. I did not find this out until August of this year (2015). Therefore, I was approved for SSI and not SSDI due to my last date of insured. I have multiple sclerosis, reflex sympathetic dystrophy, failed back surgery, degenerative bone disease, major depression and anxiety, I have had 5 left shoulder surgeries taken down to the skeleton, two spinal surgeries, and an intrathecal pump implanted for my shoulder pain. My lawyers failed to include depression and anxiety in my initial list of conditions so according to the social security office, I was told that they were going to refile my claim with the new conditions, they did this in August. I also requested for my claim to be expedited due to my living conditions. I have filled out a function report that was sent to me and I faxed it back in mid November. I was wondering if you think I will hear something very soon and if this sounds favorable for SSDI?

    • Kay Derochie

      Dear Lisa,

      Essentially you are filing a new claim, which can take from two to five months to process so you should be getting close to a decision. As you are aware, you must prove that you were disabled while still insured. It is sometimes harder to prove a medical condition that was in existence a considerable time in the past, so I really can’t predict whether your claim will be approved.

      Sincerely,
      Kay

      • Lisa Devitt

        Dear Kay,

        Would they be bias to not approve my claim due to the amount of backpay that is involved?

        Thank you,
        Lisa

        • Kay Derochie

          Dear Lisa,

          In theory, there should be no bias.

          Sincerely,
          Kay

  • Sean

    I finally spoke with my mom’s examiner (recon stage). He has advised me a month ago that he had all the information he needed..this time when we spoke he said he was waiting for the local office to clear up the question of substantial earnings. My mom supplied SSA with 2 years of paystubs as requested when she initially applied in Feb of this year because he AOD if april 2013. He advised that he does have those stubs but he was waiting on clarification from the local office. I thought that process was handled at the initial stage before the file is forwarded to DDS. He made reference to the fact that she received a lot of sick pay and needed clarity. How is he confused about sick pay?

    • Sean

      I’m just trying to piece this together from a common sense standpoint…would DDS be concerned about her work activity from 2013-2014 unless they were recommending an approval? It seems to me that if they were recommending a denial her work activity would be a non issue! Am I wrong?

      • Kay Derochie

        Dear Sean,

        The information about the work history is to determine whether she was performing substantial gainful activity (SGA) any time after she claimed disability and if so when. This information would be needed if a medical approval was being considered; however, SGA, depending on how long and when it is performed can cause a denial or limitation of a claim that would otherwise have been medically approved.

        Sincerely,
        Kay

    • Kay Derochie

      Dear Sean,

      My guess is that the examiner wants to be sure that he is not considering periods of no work (sick pay) as work days. I suggest asking the examiner exactly what he needs related to the sick pay to see whether your mother can provide the information directly.

      Sincerely,
      Kay

  • robert ridgway

    Hi Kay…..hetes a good one for ya…..had a AAA rupture 11/2013. major open heart emergency surgery to repair ascending tear…….come to find out im dissected all the way to abdomen. I go in Dec for second open heart surgery to replace valve and try and repair more of arch dissection…..wont touch abdominol, to dangerous.
    Aortic dissection is a named condition for approval on ssdi web site. Ive been denied once, on appeal. Now ssdi wants to wait 3 mo ths after this surgery to decide……i dont see why it matters. im still dissected into abdomen. Which cant be fixed.
    How can someone be turned down for having an exactly named SSDI condition for approval?
    My Dr says i cant work ever. How do they get around their own rules?
    And im still going to be dissected in 3 months….confused.

    • Kay Derochie

      Dear Robert,

      Usually decisions are deferred when there is a possibility of improvement within less than twelve months. Perhaps the decision to defer was made based on open-heart surgery guidelines of some kind. I suggest that you get statements from your attending cardiologist or surgeon that states that your medical condition and functional capacity is not expected to improve.

      Sincerely,
      Kay

  • Rina

    I have multiple disabilities but a large focus of treatment currently is for a huge rare herniated Thoracic disc that is causing spinal compression and leaves me very limited in movement.

    Do I have to undergo treatment* in order for the Social Security Administration to determine if I am disabled or not? (meaning if I refuse treatment because the procedure is not FDA approved and the dangers, can the SSA hold that against me and withdraw my benefits later if approved?). I understand that many treatments and medications come with dangers but…

    *Treatment with a non-FDA-approved dangerous epidural steroid injection without anesthesia that could puncture my lung, cause a stroke, and/or other multiple dangers including death that the orthopedic refused to attempt and referred me out to result in the Interventional Radiologist also deciding to cancel the appointment at the very last minute to warn me of this after getting a second opinion from a neuroradiologist but still willing to proceed if I want to.

    Thank you in advance for your time.

    • Kay Derochie

      Dear Rina,

      If you explain that you are refusing treatment because it is experimental treatment that is not FDA approved, the refusal of treatment probably won’t be viewed as a sign that your symptoms aren’t as bad as you claim.

      Sincerely,
      Kay

  • jb

    hello,
    i was diagnosed with ptsd, and shitzoeffective disorder back in august of this year, and my doctor and social worker at the va told me apply for ssi. I did now i received a paper requesting release of information and they are asking for a payee.Now i have received a phone call from the dds department stating to not to sign the same papers a just signed. What is this all about?

    • Kay Derochie

      Dear JB,

      It is necessary to allow release of information for your claim. As far as providing the name of a person who can serve as your payee, it is common that benefits will be paid to a third party for financial management when the disabled person has a serious mental illness. This is to assure that the rent, utilities, food and other necessities are purchased each month. I don’t know why DDS would say not to sign the forms. I suggest that you call and ask them why.

      Sincerely,
      Kay

  • Amanda

    I filed an ssi claim for my son abt 6 months ago he has adhd odd and ocdabd speech impairment so we went to the mental exam abd speech evaluation in October I hadnt heard anything do I called the ssa hotline they said first it was pending then they scrolled down further abd said that it wad processing and to call the dds and ask them. So I called and the dds examiner said she had written and closed the case and said she couldn’t tell me anything and that ill be receiving a letter, and she went on to day wrll obviously if its approval you will need to set up payee and if its a denial it will tell you what to do next. I guess my question is why did I get 2 different answers one says processing abd other says its closed what is your take on this and I haven’t received a letter yet

    • Kay Derochie

      Dear Amanda,

      The Disability Determination Services (DDS) has more detailed information than the call center because the DDS did the review. If you do not receive the letter within two weeks of your call to DDS, notify Social Security that DDS told you they had completed the review and a letter was sent. Ask for a duplicate copy of the letter.

      Sincerely,
      Kayu

  • Amanda

    Hi my name is Amanda,

    I have been getting SSDI since April of 2015 do to bi polar with psychosis and psychotic features. I went back to work part time and I make over the 780work trial period, but less then 1090 a month. I’m going to go back to work full-time making over the SGA amount will they just decrease my benefits or will they completely stop them or how long would i have for them to totally cut my benefits. I was told by someone SSA if you make more then the SGA amount for every 2 dollars you go over SSA takes away a dollar from your benefits. Is this true? Will I still be able to get some SSDI benefits.

    • Kay Derochie

      Dear Amanda,

      Social Security Disability (SSDI) benefits are all or nothing. If your health has not improved substantially so that you are no longer medically disabled, you will receive full benefits during the Trial Work Period, which is the first nine months in which you gross $780 or more, regardless of the amount you earn. For the thirty-six calendar months after the end of the TWP, you will be paid for any month you work and earn less than substantial gainful activity (SGA) level of $1,090 gross wages or net self-employment. You will not be paid for months in which you perform SGA, but your claim will remain open and you can become eligible for Medicare and even have it continue for fifty-seven months after your disability claim is terminated. You can read more about these work incentives in the Red Book, which can be obtained from a local Social Security office or viewed online at http://www.ssa.gov.

      Sincerely,
      Kay

  • Paul

    So we have the date last insured (DLI). Why does SSA want medical records after the DLI? What is the purpose of that? In my case, I have had some improvement in one medical condition, but not enough to disqualify me for SSD.

    Thanks.

    • Kay Derochie

      Dear Paul,

      More recent records are being requested either because your were found disabled before your date last insured and they want to determine whether you are still disabled up to present or the determination is that you were not disabled while insured and you are being evaluated for a Supplemental Security Income (SSI) claim that you also filed. (SSI does not have a work credit requirement for U.S. citizens and some aliens.)

      Sincerely,
      Kay

  • Joann

    My husband was hospitalized in July due to CM (Charcot). He is 50, uncontrolled diabetes and hypertension. We applied in July when he was told non weight bearing lower extremities. Its been 4 months and still non weight bearing. He has been a spray painter for 30 yrs. The foot disease he has is progressive and non curable. When he called, they said his case was sent to the state disability department (Pennsylvania) for review. When I was awarded disability, I don’t remember it going to the state for review. Any thoughts?

    • Kay Derochie

      Dear Joann,

      All Social Security Disability claims are sent to the Disability Determination Services (DDS) of the state in which the claimant resides. Given his age, limitations, and work history, there’s a good chance that your husband will be approved once the review is completed, if the limitations are expected to last twelve months.

      Sincerely,
      Kay

      • Joann

        Its been going on since July and still nothing. Do you know how long this could take? Mine didnt take that long but I was denied the first time.

        • Joann

          We called again and they said it was sent to qualiry review. Then the next person said it wasnt. They said to call this friday they have to have an answer by then. We are both freaking out about to lose everything. I dont know what to think or who to believe atvthis pount. Mine came back quick with a denial. Im so sick over this. Any idea whats going on?

          • Kay Derochie

            Dear Joann,

            Please see my response to your earlier post.

            Thank you,
            Kay

        • Kay Derochie

          Dear Joann,

          New claims can take from two to five months for a decision. You might call the Disability Determination Services (DDS) and ask the examiner whether he or she is waiting for anything from your husband or his doctors.

          Sincerely,
          Kay

          • Joann

            Thanks Kay, they daid they have everything they need. It was sent to Internal Quality Assurance. Ahe said its in house not and outside review board. Still no answer. They said we would have an answer by the 27th and still nothing. We are getting nervouse. We are going to have to tell out 6 year old santa cant come this year. Im sick to my stomach iver this. I was denied first time around and it didnt take this long.
            Joann

            • Kay Derochie

              Dear Joann,

              At this point, there is nothing to do but wait. Claims are chosen randomly for quality review so the decision, if upheld, could be an approval or a denial. You might check with your local fire department or police department to see if they know of any toy drives for needy children where you could get a gift for your child.

              Sincerely,
              Kay

              Sincerely,
              Kay

          • Joann

            Key, forst the dds said it was in internal auality assurance. The local office said it was not. Called dds back again. It neber went to review. This has been the mist frustrating thing ever. We have no idea what to think

            • Kay Derochie

              Dear Joann,

              If the claim never went for review, then you might want to call again to find out whether a decision has been made at all or the decision is still pending. If it is pending, ask if there is anything you need to submit or anyway you can help move things along.

              Sincerely,
              Kay

          • Joann

            Sorry for all the misspelled words. Very very upset. We got a phone call today that my husbands file has been sitting on someones desk and. It was approved and basically left as a decoration. My husband in just a few weeks has been having kidney issues now. I have to tell my 6 year old daughter that Santa can not come this year. I set up a go fund me. None of his 10 brothers and sisters gave called nor asked if he needed anything. Im so disgusted. Well, we went to our local office after the supervisor at the dds said its going to take extra time now since it sat. More info is now needed since its been over 60 days. He wanted us to apply for presumative ssi benefits. But, since im on ssdi he only qualifies for $24 a month and it holds up the ssdi. After crying for an hour I called the main 800 number. I told them what happened. He said my husband was approved November 6th. Everyone else says pending. Im now going to local news channels because for one he paid social security taxes for a long time. (50yrs old) and secondly, the ARMED GAURD AT THE OFFICE WAS SLEEPING !!! YES SLEEPING. This world is nuts and the government employees are sleeping on the job or not doing their jobs correctly. I was a nurse and I would of been fired for putting a life in danger. This man sure did. Im beyind angry and the system needs to change.

  • Christine

    Hi,
    I have several issues with my heart and have had cardiac arrest over 50 times in the last three years. Just had 2 surgeries and an ejection frac of around 25. I also have kidney issues. I just got a paper saying they will review medical records the 22 of december. I applied I’m June and this is not a new medical issue, I’ve had it since 2012 and was denied back then. What does this mean?

    • Kay Derochie

      Dear Christine,

      I am not sure why the review is being deferred or whether they are projecting when they can get to the claim. Based on the information you have provided, I would expect you to be approved.

      Sincerely,
      Kay

      • Vic

        What is a regional processing center? I was told that is where my claim is now.

        • Kay Derochie

          Dear Vic,

          A regional processing center includes various centralized functions for Social Security. Some have the program service center where Social Security claims are calculated. To find out why your claim is there, you will need to ask your local office.

          Sincerely,
          Kay

  • todd moreland

    Hi, I am a couple questions you may be able to answer for me and its much appreciated. I filed for SSD two weeks ago and have already have been contacted from SSA about going to see a doctor and received a questionnaire to fill out and send back. I work as an engineer on a ship and slipped on ice and hit my head. I have had radiofrequency neurotomy on neck and possible surgery for occitpital neurogia on base of skull. I have 20 years working on ships and I’m 47. My case is unique in that the US coast guard is also evaluating my medical and pretty sure they will deny me from going back on ships too work. I submitted close to 100 pages of medical of every doctor appt, pain diaries, and surgeries done. If coast guard says I’m unable too work how much merit will this hold with SSD. I am seeing doctors in Ohio and live in Florida and have been treated since Mar 2015. I know it takes time but since I had all the paperwork it seems to be moving along very well..thanks for your time

    • Kay Derochie

      Dear Todd,

      To be eligible for Social Security at your age, you have to be unable to work in other occupations for which you have transferable skills or could otherwise reasonably work if you did not have medical limitations. The consultative examination may be to try to determine issues that the Coast Guard doesn’t have to address to determine fitness for duty in your prior occupation.

      Sincerely,
      Kay

      • todd moreland

        I appreciate your info on this matter. I’ve done this job for 20 years. Medically with symptoms and meds I’m on in which none are narcotics I went from perfectly healthy to be unable to drive with the meds and unable to do any extra curricular activities. I just received word that OK m unable to be able to work on ships again. How far does SSA go back on work history? I made ovet 100k a year and disability is not an option I wished for ever. Frustrated

        • Kay Derochie

          Dear Todd,

          Depending on what your work history was before working on ships, Social Security may only look at your work on ships as your work history in terms of defining transferable skills that you may have to move into different occupations. To be approved, you must be unable to work in other occupations that you could perform if you did not have your medical limitations.

          Sincerely,
          Kay

  • Irvin

    I received a disability determination service form for a homeless applicant.. It asked question about day to day livi g and stuff like that. So i had a friend help me fill it out all though i shouldve brought it to my therapist but its was a friday that i got the form and filled it out and sent it. But i went to a therapist appointment today oct 26, 2015 and my therapist informed me that he reciebed some papers too from the disability determination services is that ok or not? Because i dont know if i dod wrong by sending the form i received back. Can anyone help with an answer? Thanks

    • Kay Derochie

      Dear Irvin,

      Some daily function forms are intended to be completed by you or by someone who knows you well and has seen you have trouble functioning because of your physical or mental condition. Those forms are to be filled out and signed by you or by a friend or relative depending on who is being asked to complete it. Other forms are sent to medical providers. As long as the right person, you or the friend, signed the form that you sent in, you don’t have a problem.

      Sincerely,
      Kay

  • Jennifer

    Hi Kay,I applied to SSDI benefits Aug 1st 2015. It is now Oct 12, 2015, I have been checking in with my claim, as of right now they said they received all the medical records (actaully mental health records, which have been signed off on ) and now the file is being sent to the “physical medical records” dept. How does that work or does it matter if my disability is 100% mental? I have no phyical limitations, just severe bi-polar which l ed to severe dependence on prespription meds were causing extreme behaviour changes which contributed to 2 job lossses. I am in intensive therapy now and am not working obviously, but money is running out and I can’t afford much more therapy at this point. Should I try to get a lawer to help me? Wondering also if I get approved if I would receive any type of back bay…..? Thanks in advance! jkammer911@gmail.com

    • Kay Derochie

      Dear Jennifer,

      I am not sure what is meant by the “physical medical records” department. It might refer to the records having been submitted as hard copies rather than electronically and may just be referring to internal workflow. If you are approved benefits will start the later of August 2014 (twelve months before your application) or your sixth full-calendar month of disability.

      Sincerely,
      Kay

  • Michelle

    Sept. 16th I had my hearing and the judge had called in an occupational therapist. On three question the judge asked her she said there was jobs and listed them, however when she asked about me being out several times a month due to my conditions or the side effects of the medicine the occupational therapist said there is no jobs I can hold. I am wondering if this is a good thing for my case it’s been 3 weeks and still not heard nothing.

    • Kay Derochie

      Dear Michelle,

      The vocational expert’s testimony is supportive of your claim. If the judge finds that the evidence supports that you have the limitations your claim, your appeal is likely to be approved. The guideline is for the judge’s decision and the decison letter to be sent within sixty days of the hearing, but it frequently takes longer.

      Sincerely,
      Kay

      • Cindy Farmer

        Long story short:

        DDS – Approved 09/04/15
        Quality Review 09/06/15
        Quality Review approved 10/05/15
        Local office informed me QR even agreed with onset date

        Now today informed file set back to DDS!

        WHY would it go back?

        • Kay Derochie

          Dear Cindy,

          My guess is that the normal routing after a QR review is for the file goes back to DDS, which in turn sends it to your local office or the payment center for processing, depending on whether or not there was also a claim for Supplemental Security Income (SSI).

          Sincerely,
          Kay

  • Austin Genay

    Hello kay ,
    I have a question.. I filled for ssd and ssi july 14 2015, had my phone interview for ssi augest 28th 2015. I got a call to schedule a evaluation exam with there doctor, witch i went to recently on september 23rd. A few days later i got a call from the lady who i guess is working on my case with ssi and ssd and said “she got my exam back from the doctor, & is sending all my information and medical records out” and to call my local ssi office in 1-2 weeks to see if they have a desision. Is this good or bad? & should i do anything, as in keep calling? Or just wait.

    • Austin Genay

      Just got a call today saying i was denyed, he said he was sending me out a form to appeal my claim. This is my first time ever applying for ssd & ssi. What should i do now?

      • Kay Derochie

        Dear Austin,

        If you believe that you are disabled, appeal with the help of an experience Social Security attorney. The appeal should be tailored to the specific reasons for the denial, so you or your attorney, if you hire one, should request a copy of your claim file. When you hire a Social Security attorney, you do not have to pay any legal fees up front and you will pay attorney fees only if you are approved for benefits. Social Security law sets the amount your attorney can charge and the Social Security Administration pays the attorney directly from the retroactive award before sending your back pay to you.

        Sincerely,
        Kay

    • Kay Derochie

      Dear Austin,

      I would say that your claim has been medically approved; but, of course, I can’t be sure.

      Sincerely,
      Kay

  • Traci

    Hello im a 40 year old female I have heart failure over 10 kidney stones surgeries in 2 years been out of work since 2011 in all a total of 29 kidney stone surgeries since 2009 .. copd night tremors depression and anxiety high cholesterol ..been denied several times ..why ? Called today and was told its with their dr for medical evaluation in charge of decision ..what does that mean and is it good or bad

    • Kay Derochie

      Dear Traci,

      Your claim is in the last stage of the review. It is neither a good or bad indicator.

      Sincerely,
      Kay

      • Traci

        Thank you for a timely response ..

        • Kay Derochie

          You are welcome, Traci.

      • lety

        Hi Kay I have a 8month old baby that needs a helmet for his head and has a hemangioma he’s taking meds for the Heart can we get approved for SSI?

        • Kay Derochie

          Dear Lety,

          Your child might be eligible for Supplemental Security Income (SSI) disability benefits if your family income and assets are below the SSI limits. I suggest that you file a claim.

          Sincerely,
          Kay

          • lety

            Thank you so much kay I will file soon!

            • Kay Derochie

              You are welcome, Lety.

  • Jeff

    Hi Kay,

    I applied for SSDI last February 2015. I was diagnosed with high blood pressure, Coronary Heart Disease, congestive heart failure, and high cholesterol. I get chest pain everyday and always feel weak, fatigue, and easily get tired. I get shortness of breath when i do any activity, even just walking for a short distance (less than 1 block).

    I was hospitalized 4 times this year already, I had an Angioplasty with stent last January. Attempted Angioplasty of the mid left anterior descending coronary artery in February (they cannot do it because the blockage was too long). Open Heart Surgery with 2 vessel last march. And another angioplasty with Stent last July 10, 2015. I stayed in the hospital for 6 days last July because I had a syncope episode.

    I applied last February 2015, Its been more than seven months since I applied and this is my initial application. Does it really take this long even if its really obvious that I meet the SSA Listing for Ischemic Heart Disease? I am 35 years old, male. I called DDS and they said that my case is with the medical staff doctor. How much longer do you think before I get a decision? thank you for taking the time to read my message.

    • Kay Derochie

      Dear Jeff,

      Your claim is very close to being decided. If you haven’t received a decision within a month, you might call back to see if it is still awaiting physician review.

      Sincerely,
      Kay

  • Tamikia N Beaton

    Hi I just call the DDS and I was my claim was sent to the automatic departments and is being reviewed by the their doctor cause they have all my medical records I’d that good or bad seem like every time I call I here something different.

    • Kay Derochie

      Dear Tamika,

      The information you got indicates that your claim is being actively reviewed and that it is moving through the process, so that is good.

      Sincerely,
      Kay

  • catrina

    After your case is seen by a dds doctor where does it go??? And how long after will I get a decision??

    • Kay Derochie

      Dear Catrina,

      I am not sure what you mean by “DDS doctor.” If had a consultative examination requested by the Disability Determination Services (DDS), the consulting doctor has three weeks to submit a report to DDS. When it is received, the DDS claims examiner will complete review of the claim. How long that review takes varies greatly depending on the complexity of the claim and office workloads. In some cases, the examiner will refer the claim to a staff doctor to review certain medical points or the decision the examiner is recommending. After that physician review, which also varies in the amount of time it pends, you should get a decision within two weeks.

      Sincerely,
      Kay

      • catrina

        If I was told a decision was made on my case,which I’m not sure if I WS approved or denied yet….why would it be in review after a decision was made???

        • Kay Derochie

          Dear Catrina,

          A claim can be randomly selected for a quality assurance review.

          Sincerely,
          Kay

          • christina

            How often does quality review change an actual decision? Is that a common occurance, or is it more frequent that some changes may simply be made?

            • Kay Derochie

              Dear Christina,

              I do not have statistics on what percentage of reviewed claim decisions are reversed. If you spend some time searching on the Internet, you may be able to find the the government statistics publication that has those statistics. A decision can be upheld, overturned, or returned to the decision maker to investigate further before the decision is finalized.

              Sincerely,
              Kay

  • Ellee

    Hello, I’m 54 and was diagnosed with severe rheumatoid arthritis within the last year. I have failed multiple drug trials, and only now have started a biological which gives me less than 20% improvement. I am in significant pain most of the time, but avoid narcotics because it worsens the mental fogginess I already have. I have LTD insurance for same occupation and haven’t heard back from SSA yet. I haven’t worked in 9 months. The stickler is that I am a physician, and my employer has sent me to Occ Med, where that provider is insisting I return to work in some capacity, using my “brain,” even though I can’t walk or use my hands to any degree. My rheumatologist and PCP feel I am totally disabled at this point. How to I navigate this quagmire of conflict? I am not fit to practice at this point.

    • Kay Derochie

      Dear Eilee,

      It may be best to hire an experienced Social Security and LTD attorney to assist you. However, here are some ideas to consider. If the occupational medicine report does not identify specific occupations you can perform, you can have a vocational rehabilitation expert review the occupational medicine report and your rheumatologist’s report about your limitations and restrictions to find out whether the vocational rehab expert can identify occupations you can perform given your limitations, including those related to chronic pain. If the occupational medicine report identifies occupations, you can have the vocational expert agrees with the assessment and, if not, why not.

      Sincerely,
      Kay

  • I was turned down first time in 2013 alj had his mind made up . Blamed my brutal job why I worked so long. I used to clean houses part time 3 -4 days no more than 20 hrs wk know my health is worst it was the back knee hand he said to have surgery. KnowI have high blood pressure goiter metabolic syndrome gglucose intolerance menopausal disorder mennorgia iregular periods my heart leaky valve & regurritates my new lawyer says I just need to prove my condition has worsen my heart has a little blockage my cardio says to take bayer 81 mg & I also take 2 meds for high blood pressure im 52 I didnt take meds before & heard that’s what the alj look for to much meds hard to work what do you think

    • Kay Derochie

      Dear Sylvia,

      I can’t tell whether you are out of your appeals period and are trying to decide whether to file a new claim or you in your appeals period and you are trying to decide whether to appeal or file a new claim. If you believe that you are unable to work, then purusing benefits in some manner would be appropriate. Either way, disability due to a combination of several medical conditions is difficult to prove, so having help from an experienced Social Security attorney is important. Your attorney has the most knowledge about your claim so I recommend that you follow his or her advice regarding a new claim or appeal.

      Sincerely,
      Kay

  • April

    I have been diagnosed with several herniated discs in my back, one of which is sitting on my sciatic nerve, and one is applying pressure around my spinal cord. I am overweight. My doctor refers to the herniations as “huge” and “very large”, unfortunately because of my weight she feels like surgery would be too much of a risk. We have made the choice to start spinal injections, with hope that it will at least provide some relief.

    I have been on medical leave for 2 weeks now and she said I can return to work on light duty with the amendment that I can not sit or stand for longer than 15 minutes without rest. No job that I know of has some sort of position like this available. Unfortunately, I am the soul provider for my household. With no income and an undefined timeline of when I could return to work with full duties, someone suggested I apply for disability. Having not gone through anything like this before is there something I should be doing just to qualify for temporary (hoping) benefits? Also what kind of information will I need to provide? Any and all help is very much appreciated. I thank you in advance.

    • Kay Derochie

      Dear April,

      To be disabled under Social Security law, you must be disabled, or expect to be disabled, for at least twelve months. It takes two to five months to get a claim decision, so you could file a claim to have it processed while you are waiting to see whether the injections help you to return to work. You can find articles on filing a claim and on the evaluation process under the “Apply SSD” and “Claim Process” tabs on the navigation bar of this website.

      Sincerely,
      Kay

  • Sheila

    Hello,
    I have had many health issues, including two strokes, a heart attack, kidney transplant, diabetes (insulin dependent for 33 years). I have applied for disability since my recent heart attack. I worked at my job for almost 20 years, and I am 52. All of my medical information has been sent to DDS and reviewed, yet they have scheduled an appointment for me to see one of their doctors. Do you know why they would need to see me, when they have all of my health information?

    • Kay Derochie

      Dear Sheila,

      I don’t know why you are being asked to attend an exam. I suggest that you call the claims examiner and say that you are willing to go to the examination; however, being asked to attend an examination when you have such extensive medical history makes you wonder whether they received everything they should have from your medical providers. Then ask to have the examiner to give you a list of the medical evidence in file and the time period covered by records to see if any key information is missing.

      Sincerely,
      Kay

  • Mel

    Hi.
    I am 43 years old & have been a stay at home mom / housewife for 23+ years. For almost 10 years I have been battling with a very debilitating diseases. Started off with chronic Psoriasis which soon after turned into the dreadful Psoriatic Arthritis & Rhumatoid Arthritis. Then comes the chronic pain syndrome, depression & anxiety.. I know that I also have Fibromyalgia, although my doctor does not believe it even exist. Just from all of the research I have gathered on my own it is easy to diagnose myself with it. I have very, very limited mobility. I made several visits to the rheumatologist, put on several different meds but nothing helped.. Finally they put me on Humira, in which I was very weary of because of the side effects, but yes I was in such Debilitating pain at that point, my family and I gave in… But the Humira injections made me so deathly ill, to where I could not even hold my head up, LITERALLY! No way I could continue…so I went back to my family doctor and told him I could no longer take the Humira.. Anyways.. My question is would I even be considered for SSI Disability if I filed? I have not been able to stand on my feet for more than 10 minutes, cannot walk from living room to kitchen without having to sit down.. When I told my doctor this he gave me a signed form for a disabled license plate tag and when I asked him about whether I should file for disability, he said he couldn’t answer that, but then handed me that signed disabled car tag? I am a very proud person, and I would not even be asking this, but I have came to that point to where I cannot do things that need done and I need to not depend and put so much on my loving husband. Please, any advice at all would be so greatly appreciated. Thank you for your time & reading this..

    • Kay Derochie

      Dear Mel,

      If your family income and assets are within the Supplemental Security Income (SSI) limits, you may qualify for benefits. I suggest that you file a claim to get a determination. You can either go to your local Social Security office or call 1-800-772-1213 to request an appointment to apply. Take documents that show your husband’s income and your and your husband’s bank account statements and any life insurance policies with you to the appointment.

      Sincerely,
      Kay

  • RON

    HELLO KAY, I HAVE PRIOR LAMINECTOMY DISCECTOMY WITH PERMANENT NERVE DAMAGE FROM 2008. HAVE BEEN BACK TO WORK AND SINCE LAST JULY HAVE TINGLING NUMBNESS BURNING COLD FEET AND LEGS MUSCLE SPASMS AND NUMB LEFT TOE. I NOW WALK WITH A CANE AFTER GOING TO CHIROPRACTOR. TAKEN NUMEROUS PAIN PILLS MUSCLE RELAXERS NERVE PILLS PHYSICAL THERAPY TWICE. AQUATIC THERAPY VARIOUS POSITION TRACTION. I AM NOW AWAITING FOR INSURANCE CO TO APPROVE MY NEUROSTIMULATOR TRIAL. I BASICALLY LAY IN BED ALL DAY WITH PILLOWS UNDER ME AND CANNOT GET COMFY DUE TO PAIN. I CAN ONLY WALK SHORT DISTANCES,SIT UP COUPLE MIN, RIDE IN CAR FOR 10 MIN BEFORE PAIN GET INTENSE. I HAVE TO WEAR CROCS DAILY DUE TO NOT BEING ABLE TO EASILY PUT ON SHOES OR SOCKS. EVEN WITH THOSE SHOES, I HAVE TO TAKE THEM OFF AFTER 10 MIN BECAUSE MY FEET SEVERLY BURNS.I WAS INITIALLY DENIED ON A RECENT CLAIM DUE TO LACK OF SEVERETY AND WITH A NOTE FOR SEDENTARY WORK. THIS WAS WITHOUT RECENT INFORMATION FROM MY CURRENT DR. I RECANTLY RECIEVED A LETTER FOR ACTIVE CONSIDERATION OF NEW EVIDENCE. I FILLED OUT THE FUNCTION REPORT AND MAILED IT IN. CAN YOU PLEASE INFORM ME OF WHAT AN ACTIVE CONSIDERATION IS AND WHAT THE NEW FUNCTION REPORT IS FOR

    • Kay Derochie

      Dear Ron,

      Please clarify a couple points so I can respond. Were you denied benefits or were you getting benefits and received a claim closure letter saying that you were no longer disabled? Which office sent you the notice and then requested the function report: the Disability Determination Services or the hearings office?

      Thank you,
      Kay

      • RON

        I WAS INITIALLY DENIED ON MY CLAIM AND TOLD THAT I COULD DUE A DIFFERENT JOB, AND I LACKED SEVERITY. THE LETTER I RECIEVED ABOUT THE ACTIVE REVIEW AND FILLING THE FUNCTION REPORT WAS THE DDS. BUT IT WASNT ADDRESSED FROM MY STATE. THE LETTER HAD THE MID AMERICA PROGRAM, IL ADDRESS. I TALKED TO PHYSICAL THERAPY TODAY AND THEY INFORMED ME THAT THEY ARE COMPILING INFORMATION TO SEND TO SSDI. THANKS FOR ANY HELP

        • Kay Derochie

          Dear Ron,

          I have not previously heard of a claim being developed after a denial without an appeal being filed; however, it is possible that the claim denial was pulled for quality review and it was found additional information was needed to be sure that the decision was in fact correct or should be changed. I suggest that you contact your local Social Security office for an explanation. Also, you do not want to let the sixty-day appeal period expire if you were planning to appeal the dneial. You should probably file an appeal before the appeals period expires, even if the current “active review” is still in process, just to protect yourself.

          Sincerely,
          Kay

          • RON

            HI KAY, MY CLAIM IS STILL AT MAMPSC AWAITING MEDICAL RECORDS AND A STATEMENT FROM MY PAIN MANAGEMENT DOCTOR.I WAS DISCHARGED FROM PHYSICAL THERAPY DUE TO MAKING NEUROPATHY WORSE DUE TO CENTRAL DISK PROTRUSION IN LOW BACK. I HAVE BEEN OFFERED A NEURO STIMULATOR 3 MONTHS AGO BUT AWAITING FINAL DECISION FROM INSURANCE. DO YOU THINK MY ODDS OF APPROVAL ARE GREAT AT THIS POINT? THE EXAMINER STATES AFTER HE GET THIS LAST INFO MY FILE WILL GO FOR MEDICAL REVIEW, I THOUGHT THIS DEPT WAS FOR PRIOR CONTINUING SSDI CLAIMS. ONCE AGAIN, THANKS

            RON

            • Kay Derochie

              Dear Ron,

              My guess is that the claims examiner at the Disability Determination Services in your state made a decision after which your claim was selected for a quality assurance review and that the review is being done at the Mid-America Program Service Center and that the review resulted in the request for more information. I do not have enough information about your work history, your age, how long you’ve had the condition, or your symptoms and limitations to offer an opinion regarding likelihood of approval or denial.

              Sincerely,
              Kay

          • RON

            HELLO KAY,
            I WENT TO MY DRS OFFICE TODAY AND MADE RECORDS SUBMIT MY FILE AND A MEDICAL STATEMENT WITH ALL OF THE PERTINENT INFO SSA REQUESTED. MY DOCTOR STATES I HAVE FAILED BACK SURG. SYN.ABNORMAL HOFFMAN AND BABASKI REFLEXES. GREAT AXIL PAIN, EPIDURAL FIBROSIS. AND WILL NOT BE ABLE TO RETURN TO WORK. MY QUESTION IS IF ALL THE CONDITIONS ARE MET THAT THE EXAMINER REQUESTS WILL MY CASE BE GRANTED

            • Kay Derochie

              Dear Ron,

              When the examiner receives all the requested information, the information will be reviewed and either more information will be requested or a decision will be made. Whether or not your claim is approved depends on how your limitations relate to the duties of occupations you have done in the past or would need to perform in any new occupation. Once you reach fifty, your age starts to be considered in determining whether you can move into a new occupation. Though a simplification, in general, after that age, the older you are, the less you are expected to be able to perform a new occupation.

              Sincerely,
              Kay

              Sincerely,
              Kay

        • RON

          THANKYOU, I HAVE FILLED AN ONLINE APPEAL. HOPEFULLY WITH THE NEW INFORMATION FROM MY DOCTORS RECOMMENDING A NEUEROSTIMULATOR DUE TO CHRONIC PAIN AND PHYSICAL THERAPY STATING THAT MY CONDITION WILL NOT GET BETTER AT THIS TIME WILL HELP OVER TURN MY DECISION. THANK YOU KAY FOR YOUR OPPINION AND HELP

          • Kay Derochie

            You are welcome, Ron.

          • RON

            AFTER REVIEWING THE MAILING ADDRESS ON MY LETTER I REALIZED MY PAPERWORK IS NOT IN MY STATE. IT IS AT MAMPSC DPB IN KANSAS,MO. WHY WOULD IT BE THERE AND IS IT A GOOD SIGN.

            • Kay Derochie

              Dear Ron,

              The abbreviation you listed is for Social Security’s Mid-American Program Service Center and Regional Office. This seems to support my theory that maybe your claim was selected for quality assurance review, which resulted in the requests for additional medical information.

              Sincerely,
              Kay

              Sincerely,
              Kay

      • RON

        HELLO AGAIN KAY,
        MY CLAIMS EXAMINER HAS GOTTEN ALL OF MY RECORDS AND MEDICAL SOURCE STATEMENT THAT HE REQUESTED WITH SPECIFIC DOCUMENTATION BEING VARIFIED. DIAGNOISED WITH FAILED BACK SYNDROME, LIMITED FUNCTIONAL ABILITIES, REDUCED DERMITONES, ARIFLEXIA. HE STATES VERY LIMITED FUNCTIONAL ABILITIES AND POOR PROGNOSIS. HE SUBMITTED MY FILE TO THE MEDICAL UNIT FOR REVIEW 5 WEEKS AGO. INITIALLY HE SAID CALL IN 30 DAYS IF I HAVE NOT RECIEVED ANYTHING. THEN HE SAID GIVE IT ANOTHER 2 WEEKS. I AM HOPING THAT MOST LIKELY MY DOCTOR WILL HAVE CONTROLLING WEIGHT. I AM WONDERING WHAT IS THE AVERAGE TIME FOR THE MEDICAL UNIT TO SIGN OFF AND SEND NOTIFICATION EITHER FOR APPROVAL OR A DENIAL?

        • Kay Derochie

          Dear Ron,

          I do not know the average time that a recommended decision pends a doctor’s review in the medical unit or what the norm is for your state. My assumption is that there is a backlog and yours in waiting its turn. If in two weeks, the letter has not been sent, I suggest that you ask the claims examiner to check to be sure your claim is just waiting in line and has not fallen through the cracks.

          Sincerely,
          Kay

          • RON

            HELLO AGAIN KAY,

            I HAVE BEEN CALLING THE EXAMINER AT MAMPSC KANSAS EVERY 2 WEEKS TO SEE IF ANY ADDITIONAL INFO IS NEEDED LIKE HE STATED IF I HAVE NOT RECIEVED A LETTER. FINALLY TODAY HE STATES HE RECIEVED AN EMAIL THAT MEDICAL REVIEW IS DONE AND HE SHOULD HAVE MY FILE FINISHED TODAY TO SEND BACK TO NC. HE STATES THAT THERE IS A LOW CHANCE TO BE PICKED UP FOR QUALITY REVIEW AND I SHOULD HEAR FROM MY LOCAL FIELD OFFICE IN A WEEK OR TWO. IF MY DOCTOR STATES I HAVE POOR PROGNOSIS AND LIMITED FUNCTION DUE TO FAILED BACK SYNDROME, AND HE SIGNED UP TO PERFORM FCE IF FURTHER INFO WAS NEEDED BUT THEY DIDN’T REQUEST IT. DO YOU THINK THIS MAY BE A GOOD OUTCOME?

            THANKS RON

            • Kay Derochie

              Dear Ron,

              I am unable to predict the outcome of your claim. If it is denied and you appeal, having your doctor perform the examination could help the appeal.

              Sincerely,
              Kay

  • Len Yabloko

    Hi,

    I am 52 and stopped working in Sep 2014 after 25 years as computer programmer due to severe depression and anxiety. I had applied fro SSDI in Oct 2014 and still waiting for decision. My questions is: can I try to do a temporary consulting work while I wait for decision? Do I need to report that work to SSA and if I fail due to my condition can this be considered UWA.

    Thank you

    • Kay Derochie

      Dear Len,

      To be eligible for benefits, you must be disabled or expected to be disabled for twelve months. If you attempt to work during that time and have to stop because of your disability less than three to six months, the work would be considered an unsuccessful work attempt. If you work longer than that and your earnings are $1,090 or more, your claim will be denied.

      If you report the work before you get a decision and you are earning $1,090, your claim is likely to be denied. Because you don’t know whether you will be able to sustain the work, you probably could wait to report the until you are approved medically (or until you appeal if denied). At that time you must report the work so it can be evaluated in determining whether you qualify given your work activity. If your consulting job will pay less than $1,090, it will probably not affect your claim and you can report the work when you start. If you try to work and have to stop, report the work as an unsuccessful work attempt.

      Sincerely,
      Kay

      Sincerely,
      Kay

      Sincerely,
      Kay

  • Debra

    Dear Kay,
    I am writing in hopes that I can get some answers. My husband had surgery in 2005 for a rare medical condition. He has a scar from his breast plate to his pelvic bone. He was on SSD from 2005-2008. Now — 10 years later, he was hospitalized several times for obstructions in his intestines and bowel. We were told that he has several hernia’s below his belly button and abdominal adhesions from the prior surgery. Surgery to remove the adhesions would be complicated for a “normal” person but it’s life-threatening for someone like him with multiple medical conditions. He suffers from idiopathic portal hypertension, esophageal varices, mesentaric verices, nodular regenerative hyperplasia (which was misdiagnosed in 2005 as cirrhosis), gastroparesis, peripheral edema, constant nausea, vomiting, motility impediments, depression, anxiety, and SEVERE abdominal pain. And the list continues. He can barely walk, stand or sit for an extended period of time. We applied for SSD in January 2015. In May we stopped by the office and they said they haven’t even begun to process his application! We gave them all the records they required in hopes that doing that would expedite it so they wouldn’t have to retrieve records themselves. We have lost everything because my income isn’t enough to support us both. He was let go from his job due to him always being out because of this abdominal pain and obstructions. With all the medications he is on, he is no longer permitted to drive. Is there anything we can do to move this process along. He is only 32 years old and has so many medical problems. His quality of life is rapidly deteriorating and I don’t know what else we can do to help him be approved swiftly. That income would at least help me pay for his medical bills and other daily living expenses for us both. I have my own medical problems so trying to get a second job or new job is out of the question because we need health insurance. Any advice would be much appreciated. Thank you in advance.

    • Kay Derochie

      Dear Debra,

      The reply to your inquiry is quite general. I suggest that you contact the Disability Determination Services (DDS) that Social Security hires to make medical decisions. You can get the telephone number by calling Social Security at 1-800-772-1213. If they don’t give you the number, call your state’s Department of Vocational Services and ask to be connected to the DDS. Once connected ask to speak to the claims examiner. Politely ask whether he or she needs anything from your husband or his medical providers that you can help get. If they are not waiting for anything, explain your dire need and ask what still has to be done to get a decision and when it might be done.

      Sincerely,
      Kay

      • Pam

        I just filed my social security disability reconsideration I will be 50 in 30 days with my reconsideration I had a letter from my doctor with different diagnosis severe copd chronic pain degenerative disc disease arthritis of knees anxiety and depression neuropathy renal blockage the first time I was denied this time I had x-rays mri reports so on so forth along with a letter from my dr with all info and stating I can’t work at this time what are my chances winning my reconsideration and am I close enough to 50 to fall into the 50-54 age bracket?just trying to get a ideal if I should go ahead and get a lawyer

        • Kay Derochie

          Dear Pam,

          The fact that you are submitting new evidence and your age is advancing could be helpful to your appeal. There is a long wait for a hearing so it might be worthwhile to engage an attorney to present the best case possible for the reconsideration. You can tell Social Security that you are getting an attorney and want the reconsideration decision held until the attorney can submit information. One way to engage an attorney is to complete the Free Benefit Evaluation form on this website. When you hire a Social Security attorney, you do not have to pay any legal fees up front and you will pay attorney fees only if you are approved for benefits. Social Security law sets the amount your attorney can charge and the Social Security Administration pays the attorney directly from the retroactive award at the time they send your back pay to you. So, it’s all very easy and risk-free.

          Sincerely,
          Kay

  • melissa lopez

    Hello kay I have a few question about a year ago my husband applied for ssi because he has a rare heart disease and had gotten a AICD IMPLANT He was denied the first time around and the lawyer is not doing there job on April 21 je was seen by a state examiner. And on May 8th a case worker called to ask my husband if he was givien any medication for anxiety he stated to her i cant take any meds of my.heart. diease and she proceeded to ask did u always havw anxiety he say no not till i received my pacemaker she then said ok thank you i am.now sending in the medical exam to in house drs what doea that mean is it a bad thing?

    • Kay Derochie

      Dear Melissa,

      Your husband’s claim is moving forward toward a decision. The phone call was to clarify a few things before the physician’s review of the consultative examination report, which is a routine procedure. He should be getting a decision before too long.

      Sincerely,
      Kay

      • melissa lopez

        Thanks kay praying for a positive outcome they said he will get his results in 3 weeks . Thanks

        • Kay Derochie

          You are welcome, Melissa.

  • Dreama

    Thank you Kay for this valuable service.

    My husband is 68 and has been layed off. Our son is 22 and lives at home. He suffers from severe anxiety, depression and ADHD. He has been in special ed since he was 6. He saw a psychiatrist from age 10 to 16 and was on multiple medications. When he turned 18 he said no more medications, no more psychiatrists (it had been 2 years since he had seen one). He has never held a job. We support him 100%. When I called SSI they said we could apply for benefits on my husband’s SSI. They suggested my husband file and suspend until 70 but that my son as well as my 17 year old daughter could start receiving payments on his claim.

    This all sounded too good to be true. And perhaps it is. When I spoke with the psychiatrist he saw for 6 years, he said he could not declare my son permanently disabled since he had not seen him in several years. I said we could set up an appointment so he could reevaluate him. He said he was reluctant to put the stigma of permanent disability on a 22 year old, and suggested I could bring him elsewhere. He also said he doubted he could qualify since he had not been in treatment for years. I have saved all the IEPs (Individual Education Plans) from his years in special ed – ages 6 to 18. I have diagnosis letters from 2 psychiatrists (including Mr. Recalcitrant) from age 6 and age 10. I have a diagnosis from 18 months ago from a psychologist who diagnosed him as suffering from an anxiety disorder, but he never went back to her for any treatment. Here is my question: Is this enough? He has not been in active treatment for 6 years but after spending his entire childhood on medication, special ed and seeing psychiatrists, and never feeling “normal” he is so over it. How do you suggest we proceed? Does he have to go back into treatment to qualify for SSI? ( sorry for the long-windedness)

    • Kay Derochie

      Dear Dreama,

      Your son may qualify for disabled adult child benefits on his father’s account if his father applies for Social Security. You must prove that your son because disabled before age twenty-two and has been disabled since then. There is not requirement that a person be permanently disabled to receive disability benefits, only disabled or expected to be disabled for twelve months. The records you have, though intermittent, might be enough to allow approval if they showed a severe, limiting condition at the time. For Supplemental Security Income (SSI) disability, which does not require work earning credits, disability only has to be proved to exist currently. Either type of claim would be helped enormously if your son would go for a current thorough evaluation, perhaps with psychological testing, and even better if he would also get into regular treatment of some kind. (Note, the longer you wait, the harder it will be to prove disability before age twenty-two.)

      As an aside, if your husband is still unemployed, it might be financially advantageous for him to take his retirement benefits now than to wait until he is seventy. A Social Security claims representative (not a service representative) can work up a calculation how long after age seventy, he would have to collect benefits at the higher rate to get back the money he turned down for the months or years before age seventy when he wasn’t working.

      Sincerely,
      Kay

  • sunie s Andrews

    I am 30 years old I have worked a little I’m most a I stay at home mom I’ve been diagnosed with AS, ADD, and IC they are now wanting to send me to a neurologist due to falling and memory loss i’m currently on file for disability they have all my medical records but they’re still wanting to send me to one of their doctors does this mean they’re going to deny me im unable to work pluses all the medication I’m on has really bad side effects I can’t drive no more I’m tired all the time I was just wondering why they would send me to one of their doctorswhen they have all my medical records from my primary doctor and my specialists

    • Kay Derochie

      Dear Sunie,

      Either your records do not have enough information for a decision or you are going to be approved and an evaluation has been requested to assess whether you are capable of receiving your benefits directly and capable of paying for your own needs. (Be sure to tell the examiner that you have a neurology referral to evaluate your falling and memory loss.)

      Sincerely,
      Kay

  • Brenda Rains

    I filed for disability after having a surgery that the surgeon accidentally cut the nerve to my left vocal chord. My voice is very limited and my activities also. I have a terrible scar in the center of my neck that stays swollen and it has been almost a year and I am dealing with severe depression and still covering up my nasty scar. I was sent to two doctors one for mental and one for voice. I applied in November of 2014 and still no decision

    • Kay Derochie

      Dear Brenda,

      Do you have a question?

      Sincerely,
      Kay

      • Brenda

        Yes sorry. I was told I was approved by 2 or 3 different people and then it was sent to quality review and the decision was overturned to not be eligible. I have hired a lawyer and now I have a large mass on the right side that is making it more difficult for breathing and swallowing. We have sent for a reconsideration what do you think my chances are?

        Thanks

        • Kay Derochie

          Dear Brenda,

          I think that you have a good chance for approval upon appeal.

          Sincerely,
          Kay

  • nicole

    Hi kay,,, I need a Ltitle insight please,,, my son has been diagnosed with aspergers last year by 3 separate psychiatrist, ,, after the last diagnosis, I applied for ssi so he can be grandfathered in to medicaid after he turns 21, he’s only 10 now,, initial intake app, went to see their doctor, never got a letter, called dd and they said I should’ve got a letter but they send my case back to local office and to give them a couple of weeks before I call, how come they couldn’t tell me what their decision was,,, I’m scared of missing the appeal deadline if it was denied,, any insight would be greatly appreciated, thanks in advance.

    • Kay Derochie

      Dear Nicole,

      Social Security and SSI claims decisions are not given out over the phone. I suggest waiting as suggested and then calling the local office to see if the claim file has been received. Say that you were told a letter has been sent but you have not received it and you need a copy of it. The appeals period, if the claim was denied, is sixty days from the date of receipt. Just a side note: I have never heard of someone being “grandfathered” into Medicaid.

      Sincerely,
      Kay

  • Renee Ditmore

    My husband was in a near fatal motor cycle accident in July. Prior to this he had applied for ssi. As a result of accident he had multi trauma most significant was brain injury a multiple fractures. He has been to the mental health exam and was diagnosed with PTSD and had a physical exam. He also has COPD and went for a function test, then sent for a dlco test and now is being sent back for a breathing test. What is going on with the multiple test? When he had his accident both lungs collapsed and they had to put chest tubes in and it took a long time to get off respirator due to low blood gas. He has scar tissue that will always be there and he had fluid between lung and chest wall. I would have thought the trauma would have been enough but it seems they are homing in on the COPD. Is this normal? Could this be considered good news or bad news in the decision? Thanks for any help.

    • Kay Derochie

      Dear Renee,

      To be eligible for Social Security or Supplemental Security Income benefits, a person must be disabled or expected to be disabled for twelve months or more. My guess is that Social Security is trying to determine what residual conditions your husband will have, if any, after the acute trauma of the accident has been resolved and that will last a year or more.

      Sincerely,
      Kay

  • LeBlanc

    Hi, Kay, I had a question. When I did my first phone interview a man had told me your SSI would be approved quicker if it severe enough. I applied in January and got my adult daily living questioniare in February and filled it out and sent it. Do you think receiving that sooner means anything? When I checked in on the status of my case DDS said they had all the documentation they needed and is pending doctor review. I was diagnosed with severe major depressive disorder in January.

    • Kay Derochie

      Dear LeBlanc,

      Physician review is one of the last steps in the claim review process. Unless the physician recommends more investigation, you should get a decision fairly soon.

      Sincerely,
      Kay

      • LeBlanc

        Hi, I just recieved a letter to attend a mental exam, so now it’s a matter of waiting longer unfortunately. But I’ll attend it and hopefully I’ll get a desicion shortly after.

        • Kay Derochie

          Thanks for the update.

          • LeBlanc

            I just went to my mental exam earlier today and the doctor was very rude to me. It’s really unfortunate to be honest. I just hope she’ll send her report to the DDS soon. How long are they allowed to take to send it?

            • Kay Derochie

              Dear LeBlanc,

              The report is supposed to be received by the Disability Determination Services (DDS) within three weeks of the examination.

              Sincerely,
              Kay

  • kimberly

    I became unable to work/disabled 9/2013.
    Applied for SSI and SSDI oct 2014
    two days ago received status update on my SSI saying,
    We are writing to tell you about changes in you SSI record,
    Your SSI is based on these facts.
    You first became disable 9/2013,
    The decisions in this letter are based on law and information in our records. This notice came from my local office..
    I thought this meant I was approved.

    however the very next day I received from DDS an appointment for medical exam

    I am confused how can I be approved but still have to have an exam
    I have not followed up with SS yet thought I would get some outside advice
    thanks

    • Kay Derochie

      Dear Kimberly,

      It is possible that after the letter was sent for the medical exam was sent, it was decided that the exam wasn’t needed for an approval. First, call the disability claims examiner who sent the letter for the exam and find out if it is still needed or a decision has been made. If he or she says the exam is still needed, explain getting an SSI approval letter. If she has no explanation, go to your local office with the two letters, if possible; or, if not, call your local office and report the discrepancy. While all this is being sorted out, don’t miss the consultative examination if the examiner says its needed.

      Sincerely,
      Kay

  • My daughter passed away a year and a half ago. She was only 17 and it was a hit and run. Now I’m suffering from uncomplicated grief, stress,fatigue, trouble sleeping, depression and thought of suiside.my family life is affected and so is my job.i also take care of my 89 year old mother and my dissabled husband. I feel so alone and now I have a phobia going to places because every time I see mother and daughter bonding I cry and my anxiety sets in. My question is, if I apply for disability is there any chance that I could get it. I have doctor and therapist that I go and diagnose me with these condition.Thank you

    • Kay Derochie

      Dear Claudia,

      First, see my response to your previous inquiry, which is posted under the article “Must I stop working before I can apply for Social Security Disability (SSD)?” where you posted your question.The article can be found under the “SSD Basic Facts” tab at the top of each page of this website. My response deals with an application for Social Security Disability.

      With regard to other types of assistance, you might check with the local social services department of your state and review your mother’s and/or husband’s health care coverage to see whether you can get some help in carrying for them and relieve your load a bit. Also if the family has not applied for food stamps, that might help the budget.

      Sincerely,
      Kay

  • Cynthia

    Hello. I am 49 years old and I previously applied for SSDI benefits in 2011, went through to the ALJ hearing and withdrew my application because new medical conditions would help with the application process. I reapplied October 2014 and submitted medical records for DJD, RA, Fibromyalgia, spinal stenosis, HBP and Chronic Pain Disorder. I was sent to a CE doctor 1/2015. The day after, the DDS worker stated she received my RFC form and medical records from my Rheumatologist and his submission will help me a lot. She also stated she is finished with her process and my case will be sent to the DDS doctor for review and then back to my local SSA office, which should take about two weeks. She said if I did receive anything in two weeks to call the local office. I would like to know, if you can answer, would the DDS worker take into consideration the previous application from 2011? Also if a case is sent to DDS doctor for review is that a good sign, or standard procedure?

    • Kay Derochie

      Dear Cynthia,

      The DDS claims examiner would not be reviewing anything in the 2011 claim. Most claims are reviewed by a physician prior to finalization of the decision.

      Sincerely,
      Kay

      • Cynthia

        Thank you very much for your help. I really appreciate it.

        • Kay Derochie

          You are welcome, Cynthia.

  • Lori

    I have applied for disability due to 2 strokes I had in June 2013. I was denied and now waiting on a hearing date with a judge. Since I first applied I have been diagnosed with PTSD and depression in August 2014. Will this make any difference in my outcome of receiving benefits? I have not worked since I had my strokes. I cannot drive or basically leave my house due to the mental issues I now have. Even if I am denied again I won’t be able to work.

    Thank you
    Lori

    • Lori

      Add to my prior comment. I am 53.7 years old and live in Indiana. I had to leave a job of 10 years.

    • Kay Derochie

      Dear Lori,

      You should be sure that the judge has all your medical records about your new mental health condition. If you have an attorney, tell the attorney and he or she will take care of it. If you don’t have an attorney, it would be a good idea to get one because getting approved based on multiple conditions can be tricky. You do not have to pay any legal fees up front and you will pay attorney fees only if you are approved for benefits. Social Security law sets the amount your attorney can charge and the Social Security Administration pays the attorney directly from the retroactive award at the time it sends your back pay to you. So, it’s all very easy and risk-free.

      Sincerely,
      Kay

  • Tanisha

    They also told me this is provisional ssi

    • Kay Derochie

      Dear Tanisha,

      The additional information that your approval is “provisional” opens another possibility. It could mean that you are being paid based on the presumption that you are disabled, which with some severe medical conditions is possible. Presumptive benefits are paid before a full medical review is done. When the full medical review is done, if you are medically approved, benefits continue; if not, they stop. Social Security Disability (SSDI) law does not have any presumptive disability provision so that claim would still be pending.

      Sincerely,
      Kay

  • Tanisha

    Hi Kay I got a call from the local office for and interview. I was told that I was approved for ssi but they told me that they don’t know if I will be approved for ssd. So will I get back pay for ssi. I really don’t understand how I got approved for ssi and ssd haven’t made a decision yet can you explain that to me please.

    • Kay Derochie

      Dear Tanisha,

      It is possible that the local office was talking about not just the medical approval, but also the non-medical review of your Social Security (SSD) claim that is done by the payment center before payment is issued. If you were medically approved for Supplemental Security Income (SSI) and the date they established as your disability onset date is in a period of time that you were still insured for SSD, then your SSD claim would also be medically approved.

      Sincerely,
      Kay

  • Tanisha

    Hi I have applied. For disability. And it have been over 120 when I called. The state office. They told me they sent my claims back to the local. Office. What. Do that mean?

    • Kay Derochie

      Dear Tanisha,

      Contact your local Social Security office and tell them that the state Disability Determination Services told you that your claim had been sent to the local office, but you have not received a decision letter. Ask what is needed to get notification. If you applied for Supplemental Security Income (SSI) and the medical decision was an approval, the local office will set up a interview to go your finances for the months your claim was pending so that they can calculate your back benefits.If the claim has been denied and it has been more than a week since the date the claim was sent back to the office, you should have received a denial letter with appeal rights. If you haven’t, find out the date it was sent and request a duplicate. You have only sixty days to appeal if you disagree with the decision.

      Sincerely,
      Kay

      • Tanisha

        I called the local office They told me that they was doing the final processing.

        • Kay Derochie

          Dear Tanisha,

          It is good you got clarity. If you don’t receive payment within a month, call and ask if they need anything from you to get the payment out.

          Sincerely,
          Kay

          • Tanisha

            Thanks I have one more question. By me getting. Provisional ssi will I get approved for ssa? I have got one check. But they also told me social security disability have to make their final decision.

            • Kay Derochie

              Dear Tanisha,

              If you are approved medically, you will begin to receive SSI benefits that are not provisional. Whether or not you also receive Social Security Disability will depend on whether you have enough work credits from past work to be insured for Social Security Disability and whether your disability began while you were insured.

              Sincerely,
              Kay

  • Holly

    Hi! My husband was recently awarded his disabilty,after a long drawn out process. Anyway,I had a question about the review he has every two years. How is the review done? How do they determine if his benefits will continue? Thank you

    • Kay Derochie

      Dear Holly,

      It sounds as if your husband was approved with a two-year medical review date because it was thought that his health would improve. If so, in two years, he will be sent a questionnaire to complete about his then current medical condition and all of his medical treatment in the preceding two years. He can submit medical records or statements from his physicians if he wants. Then the Disability Determination Services will review the information to determine whether he is still disabled. If they find he is not, benefits will stop and, if he disagrees, he will have the right to appeal.

      Sincerely,
      Kay

  • Jennifer

    Hi, I am 50 have had two heart attacks, double bi pass surgery and most recently had an biventricular ICD placement due to a low ejection fraction. Last year I had a nervous breakdown and spent some time in an extensive outpatient mental health clinic. On my cardiologist advice, I obtained an attorney and filed for SSDI have been unable to work since August 2014. I recently just recevied a notice to have a mental health evaluation performed in January which I have no idea why do you think I have a chance at getting SSDI and how close after the evaluation will they come to a decision?

    • Kay Derochie

      Dear Jennifer,

      You are being asked to attend a psychiatric consultative examination because you listed history of a mental illness and apparently there is not enough information in file to determine what psychiatric limitations you might have. The consultant has up to three weeks to submit a report. The time to review the claim after it is received can be a week or two or a month or two depending on the claims examiner’s workload at the time.

      Sincerely,
      Kay

  • Charlene Carroll

    HI Kay,

    I am a 50 year old female with severe anxiety and depression. I have worked since I was able to get a permit at age 15. My medical records have documented reports of stress and sever anxiety, panic attacks. This was from a hostile work environment and harassment from my employer for the past 3 years. After my doctor took me off work several times, she finally stated that she had had enough and she would not return me to work due to my health. She stated that my health was deteriorating from the stress of the harassment and hostile workplace and stated on my ca sdi paperwork that I could not work nor do the same type of work. The sad thing is I am 4 years away from a $3500.00 per month retirement. I know my health is more important but it is really depressing. I have been on ca sdi for 9 months. I know I can not return to work. I am not even able to go into any office without having severe panic attacks, which I have 2-3 times per week. Some last for 2-3 days. My anxiety is worse because I am so worried that I will have no income and I am unable to work. I have worked as a Legal Supervisor for 14 years and a Legal Clerk for 3 for the same company. I have 2 years of college but did not graduate. The first claims rep who received my paperwork stated she was needing documentation from my foot dr. I have had 3 surgeries in the last 6 months to reconstruct my toes from a botched surgery. I have done this while on CA SDI because I will not have insurance effective 3-1-15. I was not sure why this was needed as I was not claiming this for my disability. A few weeks ago, I received a notice to attend a Consultative Exam at a Chiropractic Office. I really don’t know if it was for a Psych Exam or Physical Exam for my foot. A few days ago I received a notice in the mail that this exam was now cancelled, do not go because Social Security had enough information to make a determination on my case. I have phoned to speak with the Determinations Specialist but they have not returned my call. The Social Security Rep that answered the phone has told me is that my case is pending. Is is a good or bad thing when Social Security cancels your appointment. From what I have read on other sites, you just never know. You seem to be most informative and confident in your responses. If you can give me your thoughts on this, I would greatly appreciate it.

    • Kay Derochie

      Dear Charlene,

      Based on your description of your mental health issues, my guess is that the appointment was cancelled because either your claim is going to be approved based on mental health or perhaps your foot treatment records indicated that your foot disability has not or will not last twelve months. If the latter is true, then I can’t speculate about whether you will be approved or not. Either way, keep in mind, I am just taking a guess and you will have to wait for the determination to know for sure.

      Sincerely,
      Kay

  • Winnie

    34 yr old ex caregiver..diabetic for five years.extreme fatigue.hypertension poor circulation in one foot(venous) becomes tight and have to prop it up often. Anxiety (trouble going out alone.depression.sleep paralysis. Do you think I will be approved for benefits

    • Kay Derochie

      Dear Winnie,

      If you are still working and earning more that $1,070 ($1,090 in 2015), I suggest that you talk with your doctors to discuss their opinion regarding what your limitations are and whether they think you are unable to continue working in any occupation. That could give you an idea of whether to stop work and apply. (You must be unable to do work you have done in the past and any other kind of work for which you are qualified based on your education, training, and experience.) If you are not working, then I suggest filing a claim to get a formal decision.

      You might also contact your state’s Department of Vocational Rehabilitation to see if you qualify for job placement or job training in a less physically demanding occupation.

      Sincerely,
      Kay

      Sincerely,
      Kay

  • myranda

    Hello, I am writing on behalf of a friend. She went to.her hearing on the 18th of November. The judge told ber that
    he was sending her for a consultative exam which she went to yesterday so what comes next.

    • Kay Derochie

      Dear Myranda.

      The consulting physician will send a report to the judge. The judge will review the report in context of the rest of the information in your friend’s claim file and render a decision. This can take a few weeks or more.

      Sincerely,
      Kay

  • amanda

    hi kay,

    i am 30 and have copd i was diagnosed when i was 25 but recently n july 2014i was placed on oxygen therapy 24/7 and i was wondering what my chances are for getting approved for disability i filed in august have yet to reveive approval/denial letter your opinion will be greatly appreciated

    • Kay Derochie

      Dear Amanda,

      You have a good chance of being approved given that you are on oxygen all the time.

      Sincerely,
      Kay

  • Angela

    Hi Kay, I am 50 yrs old diagnosis copd emphysema. Put on oxygen 24/7. Witjout the o2 my saturation levelhits 80/81.My lung Dr told me from first visit in june 2014 to apply for ssd that I wouldn’t be able to return to my job, which is Store Manager of a convenience store. My company advises me I cannot return with the oxygen. I filed in july 2014. After my lung function study was done. In Oct 2014 they sent me to a general practice Dr…. I really didn’t get that at all, but I went.. I was told by different people most likely no one is going to hire me because of the oxygen.?. 50 / 50 chance getting approved for ssd, what do you think?

    • Kay Derochie

      Dear Angela,

      It is possible that you will be approved; but don’t count on it until you get the decision.

      Sincerely,
      Kay

  • karen k

    I had back surgery in 2012 for a rupture disc now I have nerve damage will I get disability for that it was a job injury iam a cna aid.

    • Kay Derochie

      Dear Karen,

      You might be eligible for Social Security Disability (SSD) or Supplemental Security Income (SSI). If you are age fifty or older and cannot do occupations you have done in the past, then your claim will be approved. If you are under age fifty, you must also be disabled from other occupations. When you file your claim, be sure to report that you have a workers compensation claim.

      Sincerely,
      Kay

  • Dana M

    My husband was injured July 24..slammed by two cars while he on a motorcycle. He broke his neck, crushed almost every bone in his face (yes he has a helmet on) among other broken bones. He is paralyzed, quadriplegic ..a C3 Incomplete injury. He has some feeling not sensory and can move one leg a little. He has worked hard all his life..30+ yrs most of it was physical work the last 6 yrs..even when he was supervisor 7 yrs ago..he still worked on the floor and very physical. I have heard most everyone gets denied the first time..do you see a quadriplegic being denied? The dr’s cannot give him a diagnose of his future. They say you have to wait and see IF the spinal cord heals and when and if it does heal. What are the chances of him getting approved? We had a SSA person at the Spine Center Rehab (Shepherds in Atlanta GA) waiting on us and helped us with the application on the 2nd day there.

    • Kay Derochie

      Dear Dana,

      Unless there is reason to believe that your husband’s spinal injury will reverse itself within twelve months of the accident, his claim will most likely be approved.

      Sincerely,
      Kay

  • Jenny Long

    Hi Kay
    I have been diagnosed with depression, and then amended to Bipolar disorder. I have records going back to when I was 16, I have 15 years of records. 4 1/2 years ago I was diagnosed with a neuromuscular movement disorder called Dystonia. I applied for SSDI in mid June. DDS is now sending me for a mental exam. My question is how are 15 years of records not enough for them and are they going to consider how the disorders affect each other?
    Thank you for any help you can give,
    Jenny

    • Kay Derochie

      Dear Jenny,

      Apparently, there is some question that the disability examiner wants answered. I suggest that, if you haven’t already, you describe how the two conditions affect each other–either at the independent medical examination or in a letter to the medical examiner. If you are denied and you do not agree with the reasons, I suggest that you hire an attorney to assist with your appeal. You do not have to pay any legal fees up front and you will pay attorney fees only if you are approved for benefits. Social Security law sets the amount your attorney can charge and the Social Security Administration pays the attorney directly from your retroactive award at the time they send your back pay to you. So, it’s all very easy and risk-free.

      Sincerely,
      Kay

  • michelle

    I had spinal fusion 7/07 in the hopes of being able to live a pain-free life. Two weeks after, I had an accident after being cleared by my dr to drive since doing so well. The accident destroyed any good done by surgery. Ive done all injections, meds, physio….still in chronic pain, switch positions every few mins while sitting, sleeping is painful. I am on meds for depression. There is no hope of me ever being a vet tech again, but I left there in 2000, was a travel agent for a few years, then stay-at-home mom. Now that my kids are older, and I would’ve been able to work – now I can’t go back to my old profession….and we desperately need a second income now….I can’t work….I see that I’m not qualified for disability? What to do? I got a paltry sum ($35,000 after lawyer fees) from Walmart for running me over but that’s been gone.

    • Kay Derochie

      Dear Michelle,

      If you are unable to work in any of the occupations you have performed, including the travel agent work, you may be eligible for disability benefits. If you worked fairly steadily for the five years ending in 2000, you may still be insured for Social Security Disability. If your family income and assets are below the Supplemental Security Income (SSI) guidelines, you may qualify for SSI disability. The Social Security Administration administers both programs and you can apply for both simultaneously.

      Sincerely,
      Kay

  • My spouse is a disabled veteran and his civilian doctor has indicated that he is disabled. His employer stopped paying him long term benefits since they indicated that his status does not qualify as long term (currently have a lawyer for this case).

    He applied for social security benefits and they denied him saying that even though you are a disbled veteran and your doctor says you are disabled we do not consider you disabled under our criteria.

    He is going to appeal but unsure of how to present a better case once the appeal is submitted.

    Thank you in advance for any help!

    Chris

    • Kay Derochie

      Dear Chris,

      If your spouse is under age fifty, he needs to present medical information that shows he is unable to work in any occupation that he would otherwise be able to given his education, training, and experience. If he is age fifty or over, then he only has to prove that he is unable to work in any occupation he has done in the past. In either case, he has to have been disabled for twelve months or be expected to be disabled for twelve months.

      Sincerely,
      Kay

      • Chris

        Hello Kay,

        He received notification saying that VA and his doctors have indicated that he is disable but under Social Security he is not considered disabled. By the way he is under 50 and is not able to continue the work that he has been trained for and gained experience.

        He has the option to appeal but unsure what new information to present to be eligible for social security.

        Thank you.

        • Kay Derochie

          Dear Chris,

          Given that your husband is under age fifty, he has to be disabled from all occupations that he could otherwise perform, not just what he has done in the past. If he still thinks he is disabled from all occupations, he needs to address the specific reasons his claim was denied. He can find out more about the reasoning behind the denial by requesting a copy of his claim file to see the determination memorandum and to be sure all the medical information he has to submit is in file. He may also need the assistance of an attorney well-versed in Social Security Disability.

          Sincerely,
          Kay

  • Kay Derochie

    Dear Amber,

    It can take another month or two for the decision to get through the writing process especially if they are not fully staffed.

    Sincerely,

    Kay

  • kesha williams

    No the report says that i am disabled. My niece filled it out and she knows how my anxiety makes me flip out. I just wanted to know do they actually look at them once they completed the cdr. They continued them because of my medical report and i haven’t worked since then.I am afraid of people in person. In the midst of sending the form they continued my benefits. Somebody said that once they complete it, they just discard the things that they didn’t need anymore.so i was wondering how true that was.

    • Kay Derochie

      Dear Kesha,

      I doubt that the evidence used to continue your benefits is destroyed. It more likely will be archived. The new report will not raise any red flags so it will probably just be filed with the rest of your claim documentation.

      Sincerely,

      Kay

      Sincerely,

      Kay

  • kesha williams smith

    Dear .Kay I wanted to know if the DDS made the decision to continue m benefits, would a third party function report turned in late reverse the decision?

    • Kay Derochie

      Dear Kesha,

      Once you have been denied, you have to file an appeal to have additional information considered. It is a good idea to have an attorney review your claim file and help you file the appeal. You do not have to pay any legal fees up front and you will pay attorney fees only if you are approved for benefits. Social Security law sets the amount your attorney can charge and the Social Security Administration pays the attorney directly from your retroactive award at the time they send your back pay to you. So, it’s all very easy and risk-free.

      Sincerely,

      Kay

      • kesha williams smith

        I had a CDR and my benefits were continued. I wanted to know if a third party function report would reverse the decision. Do they even look at the form once they have made the decision?

        • Kay Derochie

          Dear Kesha,

          You seem to think that the functional capacity report indicates you are not disabled. It is possible that the report will get routinely filed becasue the review was completed or it might trigger reopening of the decision. The Social Security Administration is supposed to investigate any information received that indicates that a person has recovered from his or her disability regardless when it is received. You are also required to report if you are no longer disabled.

          Sincerely,

          Kay

  • david

    why did my post get taken down

    • Kay Derochie

      Dear David,

      Your comment is posted and I replied earlier today.

      Sincerely,

      Kay

  • david

    seeing one of there doctors don;t do no good i seen one and he opined that standing moving about lifting and carrying are affected by his low back pain and neck pain and alj affords him little weight said his opinion is vague

    • Kay Derochie

      Dear David,

      Have you discussed with your attorney appealing the judge’s decision.

      Sincerely,

      Kay

      • david

        i have no lawyer now they wanted me to start over i sent it in myself it also had i should avoid handleing and fingering whice is want she said

        • Kay Derochie

          Dear David,

          IF the Appeals Council denies your appeal, you can start over with a new application claiming a date after the denial date.

          Sincerely,

          Kay

  • Tina Euresti

    I am appealing denial decision, and have a lawyer. I had already submitted many medical documentation, and most were not resent but are important to my case and mental condition. I have a major problem with trusting Doctor`s and it has become very serious, and also not being able to articulate my condition has left me helpless. My disorder has affect my life and social environment. I never leave my home, and have no communication with my family. I have noone in my life to offer how much my life changed. I have never been offered to be evaluated by social security Doctor, And would think this would be valuable to my case. I need to be evacuated. My lawyer will not send me to a doctor, and have extreme anxiety to find physiatrist to help me. I did not know i have medicaid and could have found doctor i have been covered for the last 5 months. I would like to know why i have not been sent to Social security medical evaluation?

    • Kay Derochie

      Dear Tina,

      Social Security will send you to a consultative examination only if the claims examiner does not have enough information to make a decision on your claim. Not everyone is sent to a doctor.

      Sincerely,

      Kay

  • Mark Smitherman

    I just applied for SS disabilty benefits. I am 57 and have Charcot Marie Tooth disease. CMT is a hereditary neuropothy disease. It is incurable, untreatable and gets progressively worse. I believe my disease would fall under this description found in the ‘List of Impairments’
    11-04B. Significant and persistent disorganization of motor function in two extremities, resulting in sustained disturbance of gross and dexterous movements, or gait and station (see 11.00C).
    I live in Mexico, I have plenty of ‘work credits’.
    Do you have any experience dealing with SSD applicants that live outside the USA? What should I make myself aware of? Am I at a disadvantage for living outside the USA? Any advice?

    • Kay Derochie

      Dear Mark,

      If you are a U.S. citizen, living in Mexico will not impede receiving payment. Filing a successful application is more difficult because it is harder for Social Security to get the medical information that is needed. I suggest that you submit all your medical records from a year before you ceased wor. If they are in Spanish and you can afford to, have them translated, and send the translations. It would also be good to get a written narrative statement from your neurologist that lists the diagnosis, the clinical and/or test findings that support the diagnosis, and a list of your limitations and restrictions.

      Sincerely,

      Kay

  • Geraldine Lee

    Hi Kay

    I’m 47yrs old I had arthroscopy surgery on both knees, bursitis in both hips, carpal tunnel in both hands, and spinal stenosis in my back which is causing pain in my buttock and down my legs, and swelling and pain in my right feet. I applied for disability in December 2013 and it have been sent to DDS and still haven’t got a decision I called and they said they have all the information. What do you think are my chances of getting approved. I recently moved from Wilmington, NC to Montgomery, Al I talked to the DDS caseworker today and she said she will be getting information from my doctor here who I only seen once and they will be making a decision and if not they will let me know if they need to send me to one of their doctor is there anything I need to do.

    Best regards

    Geraldine

    • Kay Derochie

      Dear Geraldine,

      I can’t predict whether you will be approved or not. I suggest that you get your medical records from your previous doctors in North Carolina and submit them to DDS, if they do not already have them. Let the examiner know that you are requesting that the records be sent. you want to be sure that the examiner has the full picture.

      Sincerely,

      Kay

  • Sandra

    Hi Kay,

    Thank you in advance for your feedback, it is very much appreciated. My mother was diagnosed with stage IV chronic kidney disease and is recommended for dialysis. She is 59 1/2 years old and stopped working 2/18/2014 due to her illness. Right now she is receiving payout for sick pay and vacation pay of about $1600/month and is not on dialysis (yet). I helped my mother apply for both SSI and SSDI on April 4, 2014. On April 7th, she received paperwork to complete the Adult Function Report from the DDB. She then received a letter in the mail from SSA dated April 11th that she was denied for SSI benefits because her work credits/assets were too high. I called the DDB this morning and was told her case for SSI went to Quality Assurance and that I did not need to fill out the function report because a decision was already made by Quality Assurance and my mom should get notification in the mail. Well, my mom was approved for SSI. Some questions for you. What happens with her application for SSDI? Can she get both? Is she only getting SSI until her application for SSDI goes through? Are her chances of getting approved for SSDI good since it was approved for SSI? This all happened incredibly fast and I am so confused! I appreciate any advice 🙂

    Have a great day!

    • Kay Derochie

      Dear Sandra,

      I think that perhaps some confusion has occurred. If your mother’s assets are too high, she is not eligible for SSI and her SSI claim should not have been sent for medical evaluation. I think that the information about her claim having been sent to Quality Assurance refers to her Social Security Disability (SSDI) claim. Of course, my comments are supposition, but hopefully they give you a place to start inquiring to see if you were given correct information and/or understood the information correctly.

      Note that when your mother goes on dialysis, she will be eligible for Medicare without serving the usual twenty-four month waiting period. If Medicare does not start as the result of her current claim, she should apply for Medicare as soon as dialysis starts.

      Sincerely,

      Kay

      • Sandra

        Thank you again, in advance for your feedback.

        You were correct, my mother was approved for SSDI and she started receiving payments in August 2014 (no back pay). She started dialysis on August 5th and has a private insurance where she pays a premium and deductible. Because she is now on a limited income, we would like to have her apply for medicare/medicaid and cancel her private insurance. I touched base with the financial coordinator at her dialysis center and was given the following options for my mom (note her 20 year old son still lives with her). We understand he wouldn’t qualify for medicare and my mother is ok with this.

        Current/Option A: BCBC Individual Plan $1150 OOP,$1150 Deductible

        (both met for 2014 so 100% coverage currently)

        *Ms. Cortez and son are both covered under this plan for $100/month. The premium can be paid by the American Kidney Fund so that there is no premium cost. Annual cost for plan would then be $2300.00(starting in 2015)

        Option B: Once Ms. Cortez is deemed disabled by SSA she may be eligible for Medicaid based on her income. If she meets the income requirements through the State, then she could potentially keep BCBS as primary with the AKF paying premiums, and have Medicaid as secondary to cover her annual OOP/Deductibles. Annual cost for insurance coverage would be $0 annually.

        Option C. Ms. Cortez is eligible for Medicare Pt. B starting 11/1/2014, but this does not coordinate with the current Individual BCBS plan so Medicare would become primary. Medicare Pt. B $104.90/month and would cover 80% of dialysis. Ms. Cortez would need to obtain a secondary insurance and prescription plan that would cost approx. $75.00 for prescriptions. AKF could pay the supplemental insurance premium but not the prescription plan or Medicare premium since she will be on SSDI. Approximate Annual Cost $900 plus “donut hole” for prescriptions of approx. $2000.00. Cost is estimated at $4158.80 annually for Medicare A and B, Supplement and Medicare pt. D prescription plan.

        Looking at the above plans, option B seems like the best fit for my mom financially. However, this isn’t medicare she would be applying for, but instead medicaid. Is it in her best interest to apply for medicare instead? Why is option C so expensive. We live in Wisconsin by they way. And we are both very confused.

        Thanks again for the help!

        • Kay Derochie

          Dear Sandra,

          I am not a financial counselor, so I will keep my remarks general. Before you mother makes a decision, I suggest that you get a list of all Medicare supplement insurance companies that your mother’s dialysis center accepts and investigate the cost of the coverage for each and what they cover. You can get a list of the companies in her area and do a comparison of costs by going to http://www.medicaresupplement.com and putting in her zip code and some demographic information. It will bring up the insurances available in her location. There are also financial advisors who specifically help with insurance choices. Premium cost is one factor, but coverage and co-pays and deductibles are also important to consider. If a decision isn’t reached before November 1, be sure she enrolls in Part B. It is easier to cancel the insurance than to get it started when it has been refused.

          Sincerely,
          Kay

  • Crystal

    Dear Kay, I wanted to know what you think my chances are this time around? I’m 29 years old. I have been battling heart failure/ cardiomopthy since I was 22 years old. When I almost died the doctors found out after all the tests were done. I’m just very concerned. I can’t work and I have kids to take care of but I’m always not feeling well.Thank you so much Kay.

    • Kay Derochie

      Dear Crystal,

      I cannot predict the outcome of the claim you filed.

      Best regards,

      Kay

    • Shannon

      What was your ejection fraction?

      • Kay Derochie

        Dear Shannon,

        It is one type of measurement of cardiac (heart) function.

        Sincerely,

        Kay

  • Crystal

    Typo I ment my attorney just said I have fluid when it’s clear I have more problems than fluid.

  • Crystal

    Dear Kay, recently in February I had and interview with ssa and she told me that my claim will be sent to disability determination office later that day. I have chronic heart failure/ cardiomopthy I have applied before was denied and went to court and was denied again but the only thing my said to the alj was that I have fluid won’t hire him again.Anyway he went word for word with the vocational expert at the end she sad it’s no job that I would be able to do but I was still denied. What do you think my chances are this time around? I won’t give up this time I’m going to get a real good experience attorney. I did my function report and work history and send everything back almost a month ago. My case worker left me a message wanted to know about if I see a eye doctor. I wonder why can you give me some feed back please. I haven’t heard anything from them again yet.

    • Kay Derochie

      Dear Crystal,

      Given what you have told me, I do not see why you would have been asked about an eye doctor. I suggest you call back and ask what prompted the question or whether it was a mistake. Did the examiner mean to say a different kind of doctor?

      If you are denied, obtain an experienced Social Security attorney. You do not have to pay any legal fees up front and you will pay attorney fees only if you are approved for benefits. Social Security law sets the amount your attorney can charge and the Social Security Administration pays the attorney directly from your retroactive award at the time they send your back pay to you. So, it’s all very easy and risk-free.

      Sincerely,

      Kay

  • Jim

    Hello I have a question basically I just had a remand hearing and the judge denied me again but this time he said that I have not had 12 consecutive months period during which I did not engage in sga,,,I don’t understand this because I did not work at all from nov 2012 to present. How do they come to that conclusion? Also who determines a UWA because most of the SGA I had accumulated was less than six months at 5 different jobs. Then It goes on to state that since the decision was made at the first step that the appeals council issues are not applicable and totally writes them off? as ac cited stone vs heckler 1985 5th circuit. However in my first alj decision letter it stated I did have SGA however the next step in the process would conclude the other remaining time that I did not engage…because I am not engaging now and haven’t been and it clearly says on ss website if the claimant is not engaging and not working it will move on to step 2 How can he disregard the appeals council issues upon remand and second why would they say that there has been no 12th month period in which I did not engage in sga clearly I haven’t worked since nov of 2012! please help this all makes no since Thank You sincerely!

    • Kay Derochie

      Dear Jim,

      If you wish to pursue your claim further, you can file a second Appeals Council review. If the Appeals Council remands a second time, it will go to a different judge. If it is denied again, you would need to file suit in District Court. And, it sounds as if you need an attorney well versed in Social Security law to sort out the specifics to make an appropriate case for your appeal. Do you have an attorney?

      Sincerely,

      Kay

      • jim

        I do yes thank you!

        • Kay Derochie

          You are welcome, Jim.

  • jim

    hello. im 35 male History pad w/interm claudication (pad)
    report lower ext peripheral pvr/abi
    notes claudication
    report
    right segmental pressures
    Brachial 109
    high thigh 132
    low thigh 133
    postterior tibial 90
    dorrsalis pedis 86
    ankle/brachial index 0.79
    post exercise pressures
    brachial 121
    right ankle 36
    left ankle 107
    rt abi 0.30
    lt abi0.88.
    i also have the written report . I applaied in october of 2013 i also applied for depresssion and anxiety. i read on the ssa website that you can get automatacally approved for me would be under 4.12b . if this is the case why is the dds case worker telling me she dosent have my records and i call my doctor and they give the exact dates they were sent. and i ask the case worker and she says oh ya there it is but wants to send me for a CE. i am confused? ty

    • Kay Derochie

      Dear Jim,

      I am not a medical professional, so I cannot comment on whether your condition meets the listings, which I believe you are saying it does. I suggest that you call the examiner and tell her that you think you meet the listings and why and that because you appear to meet the listings, you wonder why you are being asked to go to an examination. If she still wants you to attend the consultative examination, be sure to do so.

      Sincerely,

      Kay

  • Teresa

    Hi Kay,
    My claim was assigned to a DDS case worker so I was hoping you could give me some advise/help on how to go about this process.

    • Kay Derochie

      Dear Teresa,

      The Disability Determination Services (DDS) claims representative will review the information in your claim file. If there is enough information to make a decision, he or she will do so, often sending the decision as a recommendation to a physician employed by DDS, who is trained in Social Security law. If the physician agrees with the recommendation, it will be finalized. If the examiner decides there is not enough information to make a decision, he or she will take whatever action is appropriate, such as requesting more information from you or your medical providers or asking you to attend an independent consultative examination prior to writing a decision. Be sure to respond quickly to any requests that re made of you.

      Sincerely,

      Kay

  • Teresa

    I have COPD and Fibromyalgia. I was diagnosed with lung cancer in June 2013 and had surgery in August 2013. They removed the bottom part of my left lung and since my surgery, although im cancer free now, my COPD and Fibromyalgia have gotten extremely worse. I am also having major panic attacks since my surgery and my pulmonary doctor wants me to see a psychiatrist to help me with this. I was unable to go back to my job due to not being able to breathe due to the chemical smells etc. I have filled out all of the paper work for disability in September 2013 as well as filling out the Adult Function Report they sent me in February 2014. They also sent a third party AFR to my mother as well and they have this to review as well now. I just found out that they have assigned my claim to a case worker for review. Can you tell me if they will deem me as being disabled and how long this this process may take?

    • Kay Derochie

      Dear Teresa,

      Please clarify for me: When you say they have assigned your claim to a case worker for review, do you mean a representative in the local Social Security office or to a claims examiner in the Disability Determination Services office. Once I know that, I can offer an opinion.

      Sincerely,

      Kay

      • Teresa

        Hi Kay,
        They have assigned my claim to a case worker within the DDS. Please let me know your thoughts and let me know if you have any advise to help me. I just do not know what to expect going through this process.

        Thanks
        Teresa

        • Kay Derochie

          Dear Teresa,

          Respond right away to any request that DDS sends you and do or provide whatever they ask. If you have a change in your health, new testing, or new medical providers let DDS know right away. Otherwise, just wait for a decision, which can take a while.

          Sincerely,

          Kay

          • Teresa

            Hi Kay,
            I had the complete PFT testing done on 4/24/14 for my COPD by my doctor and they are putting me on oxygen. I do not have to use my oxygen while I am sleeping but I need to use it for any activities and walking etc. I also received a letter from the DDS and they asked me to go to see their doctor on 4/28/14. Should I let them know what happened at my doctor appointment as well? Also, do you think I will be approved since I am being put on oxygen??

            Thanks
            Teresa

            • Kay Derochie

              Dear Teresa,

              It is likely too late to cancel your appointment on the 28th; however, you should tell the examining doctor and the Disability Determination Services (DDS) that you had the exam and tell DDS that you are on daytime oxygen. It would also be a good idea to ask your physician’s office to fax a copy of the test results to DDS.

              Sincerely,

              Kay

  • I have filed for SSD on Oct. 1, 2013, I have called them recently to ask if they have everything they need as far as records from Doctors, which they said they do. I have DDD, DJD, migraines, fibromyalgia, sympathetic dystrophy syndrome, SI joint dysfunction, creputus. They told me I would be receiving a letter soon, what do I do next if they deny me? I dont have a lawyer yet. Do you think I will be awarded benefits? I cant go on much longer.

    • Kay Derochie

      Dear Corinna,

      I cannot predict whether you will be approved or denied. If you are denied, I suggest that you get an attorney for your appeal. Because you have several different conditions–each of which might not be disabling by itself but in combination could be, your claim is a bit complicated. It could take a professional to present your situation clearly. If you have to appeal, be sure to do so within sixty days of the date of the denial letter.

      Sincerely,

      Kay

  • Stacy D. Stenson

    Hi. I recently reapplied for Social Security. I first applied in September of 2011. I was denied all the way up to appeals level. At that point my lawyer said he did not think they would overturn my case. mind you the AlJ judge I had was very , very , conservative and had the worst approval rating in the State of Texas. Anyway, in between that time I had a decision to make and decided to go with aa new application knowing that backpay is lost but I had suffered with my back pain long enough. I filed August 27, 2103 . I had back surgery October 25, 2013. I just received the function report and work history report to send back. My question is do I fill out the function report to my recent surgery , or what was going on before the surgery or a combination of both. I know my surgery is fairly new and I had a spinal fusion and I am no where near healed. It takes 3 months to see if the fusion is taking place and still there is no guarantee. Thank you for taking time to read this.

    • Stacy D. Stenson

      Correction . Filing date was Nov. 4 2013. August 27 is onset date.

      • Kay Derochie

        Dear Stacy,

        Thanks for the additional information. Please see my reply of a few minutes ago.

        Best,

        Kay

    • Kay Derochie

      Dear Stacy,

      I assume you are claiming a different date of disability so that your claim will not automatically be denied as a duplicate claim. That said, even though you are claiming a new date of disability, you would want to give a history of your medical conditions that led up to the worsening and a list of all the medical providers who have treated you.

      Best regards,

      Kay

      • Stacy D. Stenson

        Dear Kay,

        Yes I am. The reason being my representative said my case would be stronger. I was diagnosed with DDD two years ago and my doctor had suggested to me that surgery was needed, but I had to think real hard about it. Its like jumping in a frozen lake not knowing the outcome. That is where I am right now. So my medical restrictions should speak for themselves as far as my surgery? So when they ask about why I can’t do certain things base it off the pain I was in before surgery. Did I get that right? Thank you for the clarification. I had already recently given my prior medical evidence which is pretty lenghty and soley about my back problem. It was all presented the first go around. It took 10 months to get a judge hearing answer, which came August 26, 2013. . By the time my case was in the decision writing stage I had gone back to get another MRI and found out my back was worse (that was in May of this year) and I had to do the surgery when I could have someone to help me. I am going to see if my doctor can at least support me with a statement . Is there anything in specific to ask him to include in the letter? Sorry for the ranting…

        Thanks,
        Stacy

        • Kay Derochie

          Dear Stacy,

          Ask your doctor to include his opinion of whether he thinks your pain complaints are as severe as you say they are (credible) and also ask him to describe the clinical examinations and text results that support an underlying condition that could account for the pain.

          Sincerely,

          Kay

          • Stacy D. Stenson

            Dear Kay,

            Thank you very much. I will post to let you know how this goes. Have a blessed day!

            Stacy

            • Kay Derochie

              Stacy,

              You are welcome and thank you.

              Kay

  • kathy Stokes

    Hello again this is my case I was injured in a cab reck in 2004 had back surgery in 05 and then moved in 06 to texas from Detroit the was really bad for my back now I still suffer in pain everyday. I see a pain specialist every month and he gives me narcos 10/325 that I take every 8hours and I see a phych dr I. Suffer with anxiety major depression bi polar schalphianic so I take clymbata 2 times a day zanic 3 times a days risapidone 1 a day I ve been on this almost 1 yr and case been dds the same length of time what’s going on

    • Kay Derochie

      Dear Kathy,

      Occasionally the Disability Determination Services (DDS) will defer a decision to see if the person will be disabled the required twelve months; however, they send a letter saying they are doing this. If you did not receive such a letter, then I can’t explain the unusually long period of time your claim has been under medical review. If you have a contact number for DDS, I suggest you call and ask if they are waiting for anything from you or any of your doctors. If not, ask why the claim has been pending a year. If you are told they are reviewing it, I suggest asking to speak to a supervisor because a year is quite outside the norm for a DDS disability decision.

      Sincerely,

      Kay

  • Kathy M. Schroeder

    Very informative I was on ssd but sadly enough returned back to my job of 12 years only to re-injure myself permanently Am I still eligible as I tried to return to work but am no longer able to perform my job duties? I have had 3 back surgeries and I now have neuralgia and other severe problems along with stenosis severe and degenerative disk disease. Thank you for your informative video. Sincerely…

    • Kay Derochie

      Dear Kathy,

      Please tell me when you returned to work and when you stopped again so that I can respond. Also, am I correct in understanding that when you re-injured yourself, the injury was related to the condition for which you previously received Social Security Disability?

      Thank you,

      Kay

      • Wanda

        I am still working, but have been put on 2 weeks medical leave. I don’t think I will be able to stay working. I can take 3 months off for unpaid leave and have a month and a half of vacation coming. Can I apply for SSD while on unpaid leave and vacation pay or will they still consider that working? Also I could go on my late husbands SS pretty soon. Could I collect that while waiting for SSD determination? I have been experiencing increasing pain in my hands and feet with less and less strength in my hands for hanging on to files. I also am having trouble with concentration and comprehension. I am now going to a therapist to see if she can help me with stress and depression.

        • Kay Derochie

          Dear Wanda,

          If you expect to be unable to work for a total of twelve months or more, then it is appropriate to apply. Payout of your vacation pay will not be considered work. Just be sure to tell Social Security about it when you apply. You can apply for widow’s benefits while you wait for your disability claim to be processed.

          Sincerely,

          Kay

    • Camille

      I was diagnosed with lung cancer 2014,still waiting on SSI(no income) my job won’t let me work,because I can’t drive. Can anyone give me some advice

      o

      • Kay Derochie

        Dear Camille,

        If you are able to work in a job that does not require driving. I suggest that you discuss with your doctor whether it would be okay for you to work. If so, you could look for another type of work. Another option would be to check to see whether your state offers short-term disability insurance.

        Sincerely,
        Kay

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