HOW DISABILITY BENEFIT CASES ARE DECIDED
July 31, 2018
California residents should understand that there are three possible stages to a disability benefits case. The first stage is the initial application, and more than 35 percent of cases are won at this level. If the initial application is denied, the next step is the reconsideration application followed by a hearing in front of an administrative law judge.
About 10 to 15 percent of cases are won at the reconsideration level. This is because the only difference between the initial application and the reconsideration level is the person who examines the case. In most cases, the same evidence is taken into consideration. Therefore, unless the person who examined the initial application made a mistake, the request for benefits will be denied at the reconsideration level. If new evidence does become available, an examiner will take it into consideration, and that could result in an application being approved.
In the event that a case reaches a judge, an applicant has a better than 65 percent chance of obtaining benefits after the hearing. With such a high success rate, an applicant may want to skip directly to the hearing. However, the reconsideration appeal must be considered and denied before this can happen. Individuals should understand that many applications are denied at both the initial application and reconsideration appeal levels.
If a person has a mental or physical condition that results in an inability to work, he or she may obtain SSI or SSDI benefits. These benefits may provide money to pay medical bills or cover other expenses. Individuals may receive financial assistance for as long as they are totally disabled and expect their condition to last for at least 12 months. In some cases, legal counsel could help a client obtain retroactive compensation.