Tuesday, July 10, 2007

Constant Vigilance

It typically takes about six months to get a decision from the Social Security Administration (the “SSA”) when filing an application for disability benefits. If a decision has not been received by that time, it frequently means that something has gone wrong.

Regardless of whether I submit records by certified mail, fax with confirmed receipt, by hand with time stamped copy, and even when submitted electronically using the SSA’s secured website with confirmation receipt, the SSA loses submissions. When the SSA loses evidence, it tends simply to sit on the claim.

I received a fully favorable decision today on an application that should have been decided several months earlier, but was delayed because the SSA lost evidence and sat on the application. The claim had very strong medical and vocational support. When there was no decision on the initial application after six months, I sent letters and made phone calls to learn why the claim had not been approved. About three months later, I finally received a letter from the SSA claiming that it had no record of my client’s application, so I would have to file a new application all over again.

I advised the local SSA representative that I would not begin the application all over again. I added that the fact that he had sent me a notice of disapproved claim shows that he had the file at some point, and that because he had received the certified mail request for a hearing he was required to transfer the file to the hearing office.

When two weeks went by and the file was not transferred, I notified the SSA representative that I intended to hold him personally responsible, and would commence a Congressional inquiry into his losing the application and directing that a new application be filed. I warned that if he failed to drop his demand for a new application and failed to transfer the claim for a hearing immediately, I would have the claimant’s Congressman contact the representative’s District Manager to explain how he denied the claim, but now claimed that he never had it. The file was transferred within a few days.

Once the file was transferred, I filed a request for a fully favorable decision on the record, which was granted. The claimant did not have to attend a hearing, which meant he avoided the two year delay in obtaining benefits. However, because of the local office’s actions, the claimant’s benefits were delayed several months.

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