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Why Does it Take So Long to Receive Disability Benefits

HOW LONG DOES IT TAKE TO GET MY BENEFITS?

The process of applying for and obtaining Social Security Disability Benefits can take a very long time. Our region, which includes the State of Ohio and Northern Kentucky, has one of the highest application rates in the nation. This translates into a long application process. In my previous articles, I said it is important to prepare in advance of the application by talking to your treating physician, and to apply as soon as possible.

An initial application can take anywhere from 90 to 120 days for the SSA to make a decision. In my experience, the initial determination usually results in a denial of benefits. There are many reasons for this. That will be the subject of another article. However, the two reasons that come to mind are the failure of the treating source to respond to the SSA's request for information and the nature of the impairment. A claimant has 60 days within which to appeal a denial upon initial determination.

The next step is to file a Request for Reconsideration at your local SSA District Office. The claim is then returned to the Bureau of Disability Determination in Columbus, Ohio. If you live in Kentucky, your claim file will be transferred to a Disability Determination Unit in Frankfort, Kentucky. The local SSA District Offices have no role in the actual determination of disability. The Bureau of Disability Determination (BDD) will review the prior decision. They might require that you attend one or two consultative examinations by physicians or psychologists who contract with the BDD. The BDD also uses "in house" medical contractors to review the medical evidence. All of this takes time. You can wait until the BDD develops their file, or, after 120 days you can request that a determination be made on the evidence they have obtained. In my experience, more claims are denied on Reconsideration than are granted. There are many reasons for this as well. That will also be the subject of a future article.

The next step is to return to your SSA District Office to file a Request for a Hearing Before an Administrative Law Judge. The claim will be transferred to the Office of Hearings and Appeals that serves the region in which you live. Your Zip Code determines the location of the Hearing Office that will receive your claim file. Now comes the real wait.

The Cincinnati Office of Hearings and Appeals which serves the Hamilton District of Office, Clermont County, Hamilton County and Northern Kentucky currently has approximately 7,500 claims pending a hearing. These claims are divided between approximately 10 Administrative Law Judges. The volume of cases is simply overwhelming. The claims are assigned to a Judge and scheduled for a hearing based upon the date the Request for hearing is filed. Currently, it takes about 12-14 months commencing from the time a Request for Hearing is filed before a hearing is actually scheduled. The reason for the delay is budgetary. Congress is responsible for allocating resources (not benefits) to SSA for the purpose of processing claims. Writing your congressman to request help in processing your claim will not speed up the process. However, writing your congressman to request that he or she support additional funding to hire more Administrative Law Judges and Hearing Office personnel might help.

As you can see, the process is very time consuming and results in enormous financial hardship on a worker and his family. It can take a year and a half to bring a claim to resolution. Thus, if you can, it is important to plan ahead before you file an application.

WHY DOES MY CASE TAKE SO LONG TO RESOLVE?

I am often asked why it takes so long for a claim for Social Security Disability to be resolved. A typical claim in our region can take nearly two years to wind it's way through the administrative process. The Social Security Administration rules allow up to 120 days to make an initial determination. On Reconsideration, the second step, the Social Security Administration is entitled to another 120 days to make a determination. The third step, a Request for a Hearing Before an Administrative Law Judge can result in a fourteen month wait before a hearing is scheduled. So, why so long?

The answer lies in the number of applications and the amount of funding authorized by Congress to adjudicate claims. The aging baby boomers and what I call the "deindustrialization" of our regional economy results in our region (Ohio and Kentucky) having one of the highest application rates in the nation. Unfortunately, in my opinion, Congress has not provided enough funding for the adjudication process. For example, the local Office of Hearings and Appeals currently has over 7,900 applications pending a hearing. There are only 11 Administrative Law Judges in the Cincinnati local hearing office. Additionally, it takes the OHA a lot of staff time to get a claim prepared for a hearing. Rather than increasing staff levels to accommodate the increased applications, Congress has actually forced staff reductions.

It is important to understand that the local Social Security District Offices are not involved in the decision about whether or not a claimant meets the definition of disability and is thus entitled to benefits. That decision is made by the Bureau of Disability Determination in Columbus, Ohio at the initial determination and Reconsideration levels. You will rarely speak to these folks and you will never meet the physicians they use to review claims.

I can tell you from my own experience (well over 20 years), we are very fortunate that the employees at our local District Offices in Cincinnati, Batavia, Middletown, Hamilton, and Northern Kentucky, as well as at the Hearing Office, are all dedicated, hard-working professionals. They view each claimant as a "customer" who is entitled to their very best efforts. Unfortunately, the number of applications can be very overwhelming. The local District Offices are primarily involved in, among many other things, taking the initial application and processing payments in successful cases. I am amazed at how well they are able to keep track of claims. We all know that "honey attracts more bees than vinegar". Being polite and responsive to the folks at the District Offices and Hearings Office never resulted in a delayed claim.

Asking your congressman to get involved in your claim will not affect the determination, nor, in my experience, result in a faster decision. Asking your congressman to support an increase in funding for the adjudication process will result in a faster process.