Delays in the Social Security disability decision making process are well known. In Atlanta area hearing offices, you could find yourself waiting up to 2 years to get a hearing date, and then wait another 3 to 6 months for a hearing decision. Delays outside Atlanta are usually not quite as long but you could still find yourself waiting 12 to 18 months or longer.
Some disability claimants, however, don’t wait long at all. If you understand what SSA needs to make a fast decision and if you clearly identify your case as deserving of an early decision, you be find your monthly benefit check in your mailbox within 3 to 5 months.
Here’s what you need to know.
The common factor associated with early decisions involves your medical record. Although Social Security defines disability in terms of how your medical issues impact your ability to work, SSA also recognizes that certain medical conditions are so debilitating that you can win if you are able to show a definitive diagnosis and confirmation of your condition from a treating doctor.
Compassionate Allowance Cases Approved Early
1. Compassionate allowances – Social Security has identified over 100 medical diagnoses that qualify for a compassionate allowance. This list of conditions is here.
As you will see, most compassionate allowance conditions are terminal conditions like some cancers, or they are congenital conditions (like Angelman Syndrome, a chromosomal defect) that have existed since birth, will only get worse and are not treatable).
While receiving disability benefits will not cure a terminal medical condition, an early approval can take some of the stress off you and your family and allow you to live your life with security and dignity.
Terminal Disease Cases Approved Early
2. TERI cases – TERI stands for “terminal impairment” and these are cases where there is no treatment available and the likely result is death within a relatively short period of time (i.e., one year). Many TERI impairments are also compassionate allowance impairments and most arise from metastatic cancer diagnoses.
SSA’s Computer Software Identifies Strong
Cases for Early Disability Approval
3. Quick Disability Determination (QDD). Social Security has developed a computer program that is designed to identify claims with a “high probability” that the applicant will be found disabled. SSA has not released much information to the public about QDD factors but based on our observations, claims that qualify arise from very serious medical issues where “medical information is readily available.” Here’s what SSA has to say about the QDD process.
Our experience with QDD typically involves claims where there is one primary medical issue, extensive medical records and objective evidence in the form of MRI, CT and other diagnostic test reports.
To some degree QDD relies on the willingness of your treating doctors to cooperate with the disability adjudicator and to provide medical records quickly. Our experience has also been that SSA is less likely to approve a case under QDD if the medical records are supplied by the claimant – your doctor needs to respond directly to SSA.
Meet a Listing – Your Best Bet for an Early Disability Approval
4. Listing Level Cases – Social Security recognizes that there are many medical conditions which are not terminal, but are nevertheless likely to keep you from returning to any type of work for at least 12 months. These conditions are described in detail in Social Security’s blue book of listed impairments.
We have assisted many clients win an early approval by meeting a listing. More specifically listing level conditions that can be diagnosed using radiographic or other objective diagnostic tools are good candidates for an initial application or reconsideration appeal approval.
Social Security’s listings break the human body down into fourteen (14) body systems representing various types of medical impairments such as:
- musculoskeltal system impairments (Listing 1)
- cardiovascular system impairments (Listing 4)
- genitourinary system impairments (Listing 6)
- immune system impairments (Listing 14)
Within each listed system you will find specific diseases relevant to that system and required diagnostic criteria. For example, Listing 4.02 describes chronic heart failure and requires you to show that your left ventricle is enlarged greater than 6 cm, or that your ejection fraction (a measure of how much blood your heart can pump) is less than 30%.
Many of the listing criteria are very technical but all of these criteria will be familiar to your doctor.
Our experience has been that adjudicators will catch some listing level impairments based solely on their review of the medical record, but your chances go up if:
- your doctor cooperates by providing all requested medical records
- your doctor cooperates by completing a statement on the listing which confirms that your medical condition matches the level of impairment set out in the listing and that your condition is not likely to improve within the next 12 months
- we flag your case as a listing level case by setting out our argument in writing
When our firm represents a client who may be listing level, we prepare a statement on the listing for the treating doctor, and we quickly collect and submit all relevant medical records.
When the adjudicator receives our “listing packet,” he/she will take it to an independent medical consultant working for SSA and if the consultant is convinced, we will get back an early approval.
Obviously not every listing packet results in an early approval but we have had good results with this approach.
Even if Social Security does not agree with our assessment that our client is at listing level, the work we do early on is not in vain as this documentation can be resubmitted as part of an on-the-record request when we request a hearing, or it can be part of a pre-hearing brief when a hearing is scheduled.
If you have any questions about early approvals, please let us know – we’d be happy to help.