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Higher hoops for SSD applicants to jump through

Two of our clients both suffer from a common physical disability.  They have spinal stenosis (narrowing of the spinal column) in their necks, which causes numbness in their arms and chronic pain.  They can only sit or stand for short periods of time.  Both men worked for at least 10 years before their disabilities made it impossible for them to continue, so they applied for Social Security Disability (SSD) benefits and were denied at the initial application and reconsideration stages (almost 65 percent of applicants must go to the hearing stage).

There is one big difference though, one applied for his benefits at the age of 60 in 2011.  The other who is 45, applied this year.  Although it wasn’t easy or fast for our 60 year old to receive benefits, the 45 year old faces a much bigger challenge for two reasons: it is more difficult for those under age 50 to get benefits; plus, when our 60 year old applied, 64 percent of applicants who went to the hearing stage received benefits.  Now, only 46 percent of applicants win.

“Prior to March of this year the administrative law judges (ALJs — who decide cases at the hearing level) typically gave more weight to the applicant’s doctor’s opinion than to the opinion of the doctor who had been appointed to the case by Social Security,” said Kevin J. Bambury, attorney, Jeffrey Freedman Attorneys, PLLC.

“The assumption was that the applicant’s doctor knew the claimant’s medical condition far better than the SS doctor — who probably only saw the claimant once or just reviewed the claimant’s medical files.  Now the ALJs are giving equal weight to both opinions, so fewer claimants are getting benefits.”

The hearing stage is usually the second level for applicants and is reached after they have been denied benefits at the initial stage.  Nationwide, it typically takes about two and a half years for claimants to get a final decision on their claim.

“Another reason our 45 year old faces a bigger uphill battle than the one who is 60 did, is that there is a backlog of SSD cases that has grown from 700,000 in 2010 to 1.1 million.  The SSA had a goal to hire 250 ALJs and support staff each year until 2018 to get the backlog reduced, but now there are hiring freezes in the agency and the government,” Bambury said.

For anyone applying for SSD — especially someone younger, there’s a strong case for retaining an experienced attorney right from the initial application stage.  First, when you are denied at the initial application, you have a 60-day deadline to file for the next stage.  An attorney who knows the system will not miss your deadline.  Second, it is critical to have the right documentation from your physician to prove your disability both to the ALJ, and to the SS doctor who has been appointed to your case.

“You may still face a long wait in getting a final decision, but we can make sure it’s not longer than it has to be,” Bambury said.