Denial letters from the social security administration on Social Security Disability and SSI disability claims tend to be fairly generic. If you have filed a disability application in either program and the claim is denied, then you will receive what is known as a notice of disapproved claim.
The letter will typically begin by stating you are not disabled according to the rules of Social Security Disability and SSI. Following this statement will be the following:
1. A listing of the medical treatment sources that were used to make the decision. This list will usually mirror the list that you supplied to the social security office at the time of application. However, it may also include medical treatment providers that you did not list that were discovered when the disability examiner reviewed the claim. It may also omit certain sources that you listed.
Note: if some of your sources are not on this list, it does not necessarily mean that they were not used in the evaluation of your claim. It may simply mean that they were inadvertently left off when the list was typed in.
Howevever, later if your case goes to a disability hearing, you and your disability attorney will, at some point, review your social security file to determine which records were obtained by social security and if some records were not. Hearings always present an opportunity to add documentation to the file for the judge to review and this constitutes a large part of what attorneys do for their clients.
Of course, if you are concerned during the processing of a disability application or request for reconsideration appeal that not all your records are being reviewed, you can always contact the disability examiner who is handling your claim.
To do this, you can get the number for the disability determination services agency (DDS) from the social security office where you filed your claim. And when you call DDS, you can supply your social security number so they may look up your case and put you in contact with the examiner handling your claim.
2. A listing of the conditions for which your claim was evaluated (e.g. depression, degenerative disc disease).
3. A statement regarding your limitations and how it affects your ability to work. For example, on many notices of disapproved claim, the statement will indicate that while you are not capable of performing your past work, you are still capable of performing some type of other work (this is known, of course, as an "other work denial" and it is extremely common). This same paragraph will usually state that, in addition to your medical records, your age, education, and job training were used to make the decision on your claim.
4. The next section of the denial letter will state that "Doctors and other trained staff" looked at your case and made the decision. This means basically that a disability examiner (who has no medical training) did all the evaluation on your claim and before the final decision was made, a unit medical consultant--a doctor who works in the same case-processing unit as the disability examiner) briefly reviewed the disability examiner's writeup and assessment of the case before "signing off on it".
All in all, the denial letters sent to claimants by SSA are, for the most part, composed of boiler plate language. If you lined up 100 such notices of denial from 100 different claimants, the chances are good that most of them would look fairly identical. For this reason, analyzing a denial letter is not particularly productive.
The true significance of receiving a notice of disapproved claim is simply that it signals to the claimant that they should immediately file an appeal. If they have been denied after filing an application for disability, then this will be the time to file a request for reconsideration appeal. If they have been denied after a reconsideration has been completed, then they should file a request for a disability hearing.
In either instance, it may be time to consider finding a disability representative, either a disability attorney, or a non-attorney disability representative.
About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.
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