Disability And Injury FAQs
Injuries and illnesses that keep from work can cause considerable personal and financial strain. At these times, individuals and families rely on insurance policies to keep them secure. When those benefits are denied, it’s natural to have many concerns and questions. Browse our FAQs to find information and insight from our experienced disability and injury attorneys.
Social Security Disability Backlog: Why is My Case Taking So Long?!?!?Show Answer Hide Answer
Because of the Social Security Disability backlog of cases. There are so many open disability cases, it takes a long time for the SSA to process all of the claims.
Social Security’s NETSTAT report gives the average time (in months) from the hearing request date until a hearing is held for claims pending in the Office of Disability Adjudication and Review (“ODAR”). The chart can be found at the following web address: http://www.ssa.gov/appeals/DataSets/01_NetStat_Report.html
The NETSTAT report states that the wait time for the Mobile ODAR, which covers the Greater Pensacola Florida area, is currently 13 months (updated as of March 2013). This wait time does not go back to when the claim was first filed. It begins when the Request for Hearing was filed (the Request for Hearing is the second appeal, which comes after the Request for Reconsideration). Thus, it is not unusual for a hearing to take place 1.5 to 2 years after the disability application was filed!
Applying for disability is a great hardship.
The family has lost an income source, so money is tight. You want to work, but are unable to do so due to a disabling condition. The disability application process becomes even more disheartening when you find out how long Social Security takes to process the claims.
Over the last five years, Social Security’s disability workloads have grown significantly due in part to baby-boomers reaching their disability-prone years and an economic downturn with high unemployment. Since Fiscal Year (“FY”) 2007, initial disability claim receipts have increased by nearly 30 percent. In FY 2011, Social Security received nearly 3.3 million initial disability applications, over 30,000 more than Social Security received in FY 2010. Social Security anticipates receiving nearly 3.3 million applications in FY 2012 and over 3.1 million in FY 2013.
Consequently, the number of appeals has also grown, which means that the time to process the appeals has grown.
In FY 2011, Social Security received a record number of requests for a hearing before an Administrative Law Judge – nearly 860,000 requests, which is 20 percent more than it received FY 2010. In FY 2007, almost half of all claimants who requested hearings had waited more than 270 days for a hearing decision, and some waited up to 1,400 days. At the end of FY 2011, 29 percent of hearing requests were over 270 days old and virtually no cases were over 775 days old.
At the end of FY 2008, the average wait for a hearing decision peaked at nearly 18 months. Since that time, Social Security has steadily reduced the wait. In FY 2011, Social Security cut the average wait to below one year for the first time since 2003. However, this year long wait is not calculated from the date the claimant filed the initial application. It is calculated from the time the Request for Hearing was filed, which is typically from 3 to 6 months after the application was originally filed. That means the average wait from initial application to hearing before a judge is still approximately 1.5 to 2 years! I don’t tell you this to discourage you, but to let you know that the delay is due to the incredibly large number of applicants and the huge backlog of cases Social Security has pending. 3.1 million claims is a lot of claims to process.
Special Extra Earnings Credits for Military ServiceShow Answer Hide Answer
Since 1957, if you had military service earnings for active duty (including active duty for training), you paid Social Security taxes on those earnings. Since 1988, inactive duty service in the Armed Forces reserves (such as weekend drills) has also been covered by Social Security.
Under certain circumstances, special extra earnings for your military service from 1957 through 2001 can be credited to your record for Social Security purposes. These extra earnings credits may help you qualify for Social Security or increase the amount of your Social Security benefit.
Special extra earnings credits are granted for periods of active duty or active duty for training. Special extra earnings credits are not granted for inactive duty training.
If your active military service occurred
- From 1957 through 1967, Social Security will add the extra credits to your record when you apply for Social Security benefits.
- From 1968 through 2001, you do not need to do anything to receive these extra credits. The credits were automatically added to your record.
- After 2001, there are no special extra earnings credits for military service.
How You Get Credit For Special Extra Earnings
The information that follows applies only to active duty military service earnings from 1957 through 2001. Here’s how the special extra earnings are credited on your record:
Service in 1957 Through 1977
You are credited with $300 in additional earnings for each calendar quarter in which you received active duty basic pay.
Service in 1978 through 2001
For every $300 in active duty basic pay, you are credited with an additional $100 in earnings up to a maximum of $1,200 a year. If you enlisted after September 7, 1980, and didn’t complete at least 24 months of active duty or your full tour, you may not be able to receive the additional earnings.
Do You Help Claimants Apply For Social Security Disability?Show Answer Hide Answer
Yes. I accept representation of clients at all stages of the claim process. I help disabled individual claimants apply for Social Security disability, and I help them file appeals when they’ve been denied. Many attorneys do not take claims at the initial application stage. This is often due to the fact that the initial application takes a long time to complete. At my prior firm it was the general policy that we did not accept claims until the claimant had applied for benefits and been denied. However, after repeated requests from claimants for assistance from the very beginning of the claim, I decided to assist qualified claimants at the initial application stage from the very beginning of the case.
What are the attorney fees in Social Security cases?Show Answer Hide Answer
The attorney fees in Social Security cases are set by the contract you sign with the attorney representing you. In most cases, the fee is twenty-five percent (25%) of any past due benefits owed to you when you win your claim. There is of course a fee cap in fee agreement cases. Since June 22, 2009, that fee cap is $6,000.00 for work done during the administrative appeal process (in other words, at all stages until the claim goes to Federal Court). You may have a fee cap of $5,300.00 for contracts before June 22, 2009.
Social Security must approve any fee contract between you and your representative.
Once the back due benefits are computed by the Social Security Administration, SSA will issue a Notice of Award detailing the benefits owed to the claimant, and the amount being withheld to pay the fee. In most cases, Social Security will send the fee directly to the attorney and you will receive the remainder.
How do I apply for Social Security disability benefits?Show Answer Hide Answer
As I explain to people there are four ways to apply for disability benefits. I’ll outline each below, and describe what I call the “pros and cons” of each method.
1. First, you can contact an attorney to help you through the entire process.
Despite what you may hear “on the street”, you do not need to be denied multiple times before you hire an attorney. In fact, an attorney like me may be willing to assist you from the very beginning of your claim by helping you apply for your benefits.
Other people say you do not really need an attorney to file for benefits. They are correct. I would never tell you that you must hire an attorney to file. However, there are some advantages to hiring an attorney from the very beginning:
- An attorney can assist you in developing a winning “theory” of the case. This is the legal argument that you will use to persuade the individual deciding your claim that you meet one or more of the eligibility requirements for disability.
- An attorney can help make sure the most important issues are highlighted and developed in your claim from the very beginning.
- An attorney can remind you of important paperwork that must be submitted, and remind you of medical examination appointments you may need to attend.
- You will have someone there to answer questions you may have about each stage of your claim, and why Social Security may be doing what it is doing.
- An attorney can assist you in obtaining and developing the critical medical evidence and records necessary to win your claim.
- An attorney can assist you in supplying Social Security with all of the evidence they require to conclude the claim.
- An attorney can help you quickly and efficiently navigate the appeal process.
The only “con” to hiring an attorney from the very beginning is that you would of course have to pay an attorney’s fee on any “back benefits” you are awarded. Keep in mind, however, that you do not have to pay any attorney’s fee if you do not win, and if you win early in the claim your fee may be much smaller than if you win later in the appeal process (as there will be a larger back due benefit from which the fees are paid if the claim is open for a long time).
2. Second, you can apply over the phone.
You can call Social Security’s toll-free number, 1-800-772-1213 (TTY, 1-800-325-0778) between 7 a.m. and 7 p.m. Monday through Friday to schedule a telephone interview. The phone interview will not happen right away. In fact, because the phone interview may take as long as a few hours, the interview may not be scheduled until a few weeks after this first contact.
- Many feel the convenience of having a Social Security representative guide you through the process is welcome. The claimant does not have to worry about what to write in response to a particular question on a form.
- Even though the appointment may not be until a few weeks after the claimant first contacted Social Security, SSA will consider the application filed as of the date the claimant first called Social Security. This is referred to as the “protected filing date”.
- The application should be completed without further delay.
- Processing on the application will not begin until after the scheduled telephone conference is concluded.
3. You can go in person to your local Social Security office to apply.
Our local office is located at
823 E. Jackson Street, Pensacola, FL 32501. The telephone for our local office is: (850) 898-9904.
- As above, many feel the convenience of having a Social Security representative guide you through the process is welcome. The claimant does not have to worry about what to write in response to a particular question on a form.
- The application should be completed without further delay.
- The local office can be a little busy and chaotic. The waiting room can be a little overwhelming for some people.
- You may have to wait awhile until your appointment. In other words, it may not start right on time.
4. If you are an adult, you can apply for disability benefits online.
If you are under age 18 or your are applying for disability benefits for a child, you can fill out some of the necessary information online, but you must contact Social Security to complete the application process.
To find out how to apply, please choose the type of benefits you wish to apply for:
- You can fill out the information at your convenience.
- You can even pause the application and return to it at a later date.
- There is no one to push you to complete the application.
- Many begin the process and do not see it to completion.
- You need to have internet access.
Whichever process you take is a personal decision. Just to note: if it were me, I’d choose the first option! Call me at 850-912-9919, or fill out the form, for a FREE consultation.
How Long Will I Have to Wait for my Disability Hearing Before a Social Security Administrative Law Judge?Show Answer Hide Answer
Most of the hearings in our area are handled out of the Mobile, Alabama Office of Adjudication and Review (ODAR). According to a Social Security Publication issued in March 2013 (you can click here for the report entitled “NETSTAT Report”), the wait time for a hearing in our area is approximately thirteen (13) months. Yes, you read that correctly. Over one year. And that is not the worst of it. The average thirteen months does not run from the initial application. It runs from the time the claimant files the second appeal (the Request for Hearing).
What Are My Chances of Winning My Disability Case?Show Answer Hide Answer
This is an impossible question to answer with certainty because of the number of factors that go into the decision. These factors include, but are not limited to: your age, your education, your work history, your type of disabilities, your earnings record, the medical evidence submitted in support of the claim, and the Administrative Law Judge assigned to your claim. That being said, I like to tell my clients, “I would not have taken your case if I did not think there was some way of winning it.” This is because I do not earn a fee unless the claimant is granted benefits.
All that being said, you may be interested in the following statistics and data points to evaluate your chance of winning. There are several valuable resources on the web to research your Administrative Law Judge’s approval rate. Below are some of these resources:
1. Social Security’s own ALJ Disposition Data.
If you go to http://www.ssa.gov/appeals/DataSets/03_ALJ_Disposition_Data.html, Social Security provides you with the “disposition data” for all Administrative Law Judges “ALJ”s across the country. This data includes the following information for each Judge:
- ODAR Assignment (the ALJ’s Office of Disability Adjudication and Review office, or home office);
- Dispositions (the number of decisions the ALJ has issued);
- Total ALJ Dispositions Across All Offices (the ALJ may have issued decisions in another jurisdiction or office)
- Decisions (number of decisions issued)
- Awards (number of cased that were granted, or won)
- Denials (number of cases that were denied)
- Fully Favorable (number of wins where the claimant won every issue or argument)
- Partially Favorable (number of wins where the claimant won, but only some of the issues)
In short, if you know the name of the Judge assigned to your claim, you can determine your exact “chance” of winning.
For Mobile, Dothan, Pensacola, Fort Walton Beach, and other cities in Northwest Florida and Southern Alabama, The ODAR you should review is for Mobile, Alabama. This ODAR covers our area.
2. These statistics were prepared by the Social Security Office of Disability Program Management Information (SSA ODPMI) on November 10, 2010 for Fiscal Year 2010. Here are the statistics for FY2010:
- There were 3,045,135 applications for disability. 35% of the applications were allowed; 65% were denied.
- Only 719, 270 of the approximately 1,979,338 that were denied filed the first appeal called a Request for Reconsideration. Of these, only 13% were allowed benefits. 87% continued to be denied.
- 619,887 claimants filed a second appeal requesting a hearing before and Administrative Law Judge. Of these, 62% were allowed; 13% were dismissed; and 25% were denied.
- Of those that continued to be denied, 83,008 claimants filed a third appeal with the Appeals Council. Of these, only 2% were allowed; 2% were dismissed; 22% were remanded or returned to the judge for further consideration; and 74% continued to be denied.
- 12,143 of those denied by the Appeals Council filed a federal lawsuit against The Commissioner for the Social Security Administration in a United States District Court. Of these, only 4% were allowed; 9% were denied; 47% were remanded for further consideration; and 40% were denied.
The above statistics are for all claims nationwide. The next document lists the Allowance Rates at the Initial and Reconsideration Adjudicative Level for Fiscal Year 2010 by Nation, Region and State. As you can see, 32.7% of all claims are approved at the initial application stage; 67.3% are denied at this stage. And only 13.1% of claims are approved at the reconsideration stage (the first appeal); 86.9% are denied:
3. You can visit www.disabilityjudges.com for statistics about hearing offices and judges that have already been computed for you.
You can search by the Judge’s name for statistics about that individual judge. Or you can click the Select a State button to try and find a judge or an ODAR office by State.
What are the Social Security Disability Appeal Deadlines?Show Answer Hide Answer
Yes. There are Social Security disability appeal deadlines. You only have sixty (60) calendar days from the exact date on an unfavorable decision to file an appeal. In the State of Florida, if you are issued a Notice of Disapproved Claim on your Retirement, Survivors, and Disability Insurance claim or your Supplemental Security Income (SSI) claim, you must file a Request for Reconsideration to protect your appeal rights. There is a Social Security form for this appeal, Form SSA-561-U2. If you are issued a Notice of Reconsideration on your claim(s), you must file a Request for Hearing By Administrative Law Judge, Social Security Form HA-501-U5.