Unlocking Legal Jargon: How AI Legalese Decoder can Expedite Your First Application Process
- April 15, 2024
- Posted by: legaleseblogger
- Category: Related News
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## Seeking Help for Health Concerns in the Workplace
Hello.
I am a young professional in my 20s who has recently been experiencing health issues. Initially, I attributed these problems to my own carelessness, but it turns out that I have discovered that I am immune deficient and dealing with several other health issues as well.
Despite my love for my job, my doctor’s case managers have advised that working is putting a significant amount of stress on my body. As a result, they have suggested that I apply for partial SSDI benefits and reduce my working hours to alleviate some of this stress.
It has been nearly a year since I started this process, and I am unsure if the timeline is normal for a first-time applicant.
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Ive been waiting 3 years in July. I had my first hearing January 25th of this year and still have not gotten a decision back from the judge. Yes, that’s completely normal to wait a lifetime
There is no such thing as “partial SSDI”. Social Security disability is for those who are fully disabled. Your doctor doesn’t decide whether you qualify, SSA will.
Yes, it’s normal since most people, when applying, do not have a catastrophically debilitating condition, other things must be considered to determine eligibility for Disability benefits. From application submission to getting a decision typically takes 10 to 12 months to get, sometimes, a bit longer.
For those looking in, here is what is happening:
* At Step 3 of 5, the SSA is determining the severity of the alleged condition to see if it qualifies for an immediate approval of benefits. If it does, the application will reviewed, signed off on and be sent for payment processing.
* If the applicant does not get an approval at Step 3, their application moves to Steps 4 and 5 where their case will be largely decided on expected functional limits of the conditions and the **Functional Work Abilities** criteria by sending the applicant to either one or two SSA doctors for further evaluation.
* Essentially, the SSA will verify the condition, its severity and prognosis and attempt to determine if the applicant can do their current job, past job, a similar job, a new job or adapt to some other job such as a menial, low level, entry level type. It’s at these Steps (#4 and #5) that basically all denials come from which in turn, bear out the overall 70% statistical Denial rate.
* **”Functional Work Abilities”** are one’s abilities to do things like: sit, stand, see, hear, speak, carry, persist, remember, communicate socially, understand, concentrate, adapt and etc. These abilities, as determined by the SSA, are used at Steps 4 and 5 to determine if an applicant can do their current job, past job, a new job, some other job or, any job at all because, at Work’s fundamental core, these are the abilities needed to do it, regardless of the job being done. Related to Functional Work Abilities, watch this video from a doctor who does SSA Disability Exams: [https://www.youtube.com/watch?v=bhTqTtGOIkI](https://www.youtube.com/watch?v=bhTqTtGOIkI)
Four pieces of info + any 3rd Party supporting evidence are used by the SSA to determine an applicant’s Functional Ability to Work:
1. The statements on the Adult Function Report (Form SSA 3373 BK) the applicant filled out long ago
2. Expected limits of the alleged condition: the SSA already knows them
3. Results from the Medical Consultation Exam and Mental Health Psych Exam
4. The summary Residual Functional Capacity documents (the RFC), Form SSA 4734 BK and Form SSA 4734 FP-Sup created from the two exams – Google them to see the criteria info being evaluated.
Historical statistics demonstrate that it is highly unlikely that the condition(s) being alleged and the statements on the applicant’s Adult Function Report submitted long ago, will match up and or, be supported by the the fact finding of the SSA. Those facts, when combined with the applicant’s age, education, job skills and experience, will likely show the applicant has the Functional Ability to Work and thus, a Denial being issued.
If one wishes to appeal the denial by asking for Reconsideration (Recon), that process usually takes another six months or so and, has a 88% statistical likelihood of resulting in another Denial. In other words, at Recon, one is about three times more likely to be denied than at Initial.
**Finally,** Whether just beginning the SSDI app process or for those on any of its 5 Steps, the link below graphically illustrates (in sequential order) the decision making steps the SSA uses to determine disability eligibility: [https://www.ssa.gov/policy/docs/rsnotes/rsn2013-01.html](https://www.ssa.gov/policy/docs/rsnotes/rsn2013-01.html)
Notice the first decision on the chart is about financial eligibility — making SGA ($1550 per month before taxes). The second step is about having a “Catastrophically Disabling Condition”. Step 3 is about how severe the alleged condition is and its impact on current work are. Step 4 deals with being able to do past or similar work based on the claimant’s skills, education and experience. Finally, Step 5 is about doing any work at all. Notice that 5 of 7 outcomes within the evaluation / decision making process will result in a denial.
Some people it takes ten years.
Yes. It’s horrible, but yes.
If you are working right now, even part time, you are probably going to be denied.
You have to have two years of medical records showing you are so disabled you are unable to work.
If you’ve been working the last few years with this disability you will probably be denied.
There is a ticket to work program, but you have to already be on disability and there are stipulations that go along with it.
You can’t just work forever and collect disability at the same time. That defeats the purpose of going on disability.
Only the unhoused and returning citizens have expedited services but only IF they use a SOAR Case Manager to apply for them.
I believe the massive delays are because many government agencies are understaffed ( not to mention many agencies still have staff “working” from home……and a lot of people apply who are not remotely qualified but their applications still have to be processed only to be denied. Having an ailment alone is not nearly enough to qualify but that doesn’t stop people from trying, creating a ridiculous backlog.
It’s taking 5+ months for cases to even be assigned to folks where I live plus mail is slow, etc. Some go faster, some slower.
It was 15 months for my first denial there is no time frame and those percentages on the website don’t mean anything as I was told by a worker that called me on my case .I just got denied now I have a attorney!
I’ve been unable to work since March 2022 after a few years of FMLA/short term and I finally came to a pt that year where I accepted filing for SSDI was what I needed to do.
As far as timeline – I applied a few months before you (from what this looks like) and mine is still airing at 70 something percent.
I know it can vary a lot by where you live. I’m trying to emotionally prepare for the inevitable denial after reading some of the posts here.
Idk your situation but tbh idk the likelihood of you getting approved for anything since (technically) you’re still saying you have some ability to work.
It’s awful and I don’t think it’s right at all but based on your info that’s my take and I want to be honest with you.
3 years later and many appeals and finally had an hearing for ssdi this previous week. I think I finally got it though. It’s tough, they’ll loop you through the system and drag it out
Do you have short term disability insurance through your job? My husband did.
When he was recovering he would go in for a few hours. Short term paid him for other hours. Making him whole.
I’m 58 and worked all my life. I applied for SSDI June 2023 and it’s 75% completed. I am hoping June 2024 I will get an answer. Sounds like this is normal.
If you haven’t already, I would highly recommend a disability lawyer. Yes sometimes it does take this long. My bf has been fighting for 4 years. I was lucky enough to have it approved in 15 months. And I think the fact that I had a great attorney plus years of case evidence really helped. If you’re working, you’re more than likely going to get denied because they look at it like you can still work, so why all of a sudden do you need to stop? Also, please note, SSI benefits do NOT pay as much as people think. So be prepared for a more than likely drastic income drop. Yes SSDI does pay more, but I would look up the maximum benefit amount allowed in your state and see if that would be feasible for you.
Another thing, given you’re only in your 20s, you may not have enough work credits for ssdi, which means you can only get ssi..: I’ll just say this, in Ohio, the max amount you can receive is $934, and most people do not get that. Despite working and only being 2 credits short for SSDI, I only receive $628 a month for ssi.
I also have both mental health and physical impairments (that will last me a lifetime, mind you) and I have to have my case reviewed in 3 years.
I can’t just go buy a car, housing? Limited to income based which is never in good areas. Yes I qualify for food stamps, but even though I do not meet the income limit, some how they got cut in half every month!
I’m not saying ssi is a bad thing… but just know that “getting money every month without working” isn’t all that great. I miss working.
Yes you can still do work while getting these benefits, but just remember, you can only receive so much extra a month before they start reducing your payments.
Good luck, and please do lots of research to see if this is really a route you can take/afford.
Ummmm, you’re in your twenties. You’re not terminally ill. Work instead of trying to get on disability. You’re going to get denied anyway.
I received my denial in less than 60 days on the initial application that my lawyer filed.
I’m at 90% filed March 23. It’s still says 10 months and at the top yesterday it went from 368 days to 370 days lol. I just ignore it from what most of the people say on here.
It took me eight months for first decision but I’m on SSI not ssdi
Quick question I saw a few people say keep going to the doctors while your waiting, but how do you do that if you have no insurance and you have not qualified for Medicare or Cade yet and can’t afford to see a doctor
Are you just racking up this medical debt and going bankrupt later? Please excuse my ignorance.
What is the quickest and cheapest way to still go to doctors and get mri and medical exams and stuff while waiting for ssdi claim.
For example you had a major surgery your work insurance runs out after 4 months you can’t afford 900$ month to cover cobra cost and your insurance runs out while your still paying off the quarter million dollar surgery monthly. What path of least resistance do you suggest I take to get medical coverage while still in recovery from said surgery.
Yep. I applied in January 2013 and I got my denial in August and that was actually pretty fast back then
I applied in January 2019 (my third time) and finally got my approval in July of 2023 after also having to appeal twice. It’s just insane.
3 years here
I am in heart failure and have pulmonary hypertension along with a myriad of other health issues. I’m also 61. I keep working even though I shouldn’t because I wouldn’t get SSI before retirement anyway (and I still need to be able to buy food).