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How is a Social Security disability claim processed?

Many people in Southern California seek Social Security Disability Insurance benefits every year, yet the nature of the review and decision process remains hidden behind a curtain of complex federal regulations. An understanding of this process can benefit every person who is contemplating making a claim for SSD benefits; this post will provide a summary of how the Social Security Administration reviews and decides whether to approve a claim for benefits.

An application for disability benefits must be filed at a Social Security field office. The SSA maintains many such offices in California, and the location of the nearest such office is available online and by telephone. An application can be filed by mail, in person, by telephone or online. Once an application for benefits has been received, the field office will verify the nonmedical eligibility requirements, such as age, employment, work status, marital status and the number of work credits accumulated by the applicant.

If the applicant has accumulated enough work credits is otherwise eligible, the application is forwarded to a Disability Determination Service. A DDS is a state agency that is responsible for determining whether the claimant is disabled or blind. The DDS uses information provided by the applicant, the applicant's medical providers and the applicant's employers. After this information is reviewed, the DDS decides whether benefits should be awarded. If the decision is favorable, the payment of benefits begins forthwith; if an application is denied, the applicant is so informed and instructed about the various forms of appeals that can be taken.

The SSD appeal process involves several steps and can be quite lengthy. The first step is an internal review by a different adjudicative team that was not involved in the initial determination. If the claim is again denied, the claimant can request a hearing before an administrative law judge. If the ALJ rejects the claim, the applicant can request another internal review and, if the claim is again denied, bring a lawsuit in federal court. As may be imagined, the services of a lawyer who specializes in handling SSD claims can be quite helpful in preparing and filing the claim and in pursuing an appellate remedy if the claim is initially denied.

Source: Social Security Administration, "Disability Evaluation Under Social Security, Part I - General Information," accessed on Nov. 21, 2016

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