My claim for SS disability was denied last summer and I appealed and have received notice for my request for a hearing before an ALJ.
Then unexpectedly yesterday I received the following letter from SS. "This determination is based on another review of your claim. As a result of our additional review, we are able to make a fully favorable medical decision and find that you meet the medical requirements for disability benefits. The onset of your disability is established as of January 18, 2008. Therefore, it is not necessary to have your case decided at the hearing level. We have not yet made a decision about whether you meet the nonmedical requirements, but we will make that decision soon. You will soon get a notice about the amount of your payments if you meet the nonmedical requirements."
This seems positive to me but 1) is this normal for them to do another review after I appealed the 1st denial?, 2) what are nonmedical requirements?, and 3) anybody care to guess how SOON the decision will be made?
Thanks to anyone who cares to comment.
Full Version: Notice Of Decision Letter
I read this as SSA is granting your claim as Fully Favorable.
carlie
carlie
congratulaltions,
You won your claim now the SSA is doing the intangeable items like quarters paid in and the minor qualifying criteria.
Thats it.
John
You won your claim now the SSA is doing the intangeable items like quarters paid in and the minor qualifying criteria.
Thats it.
John
So you should get a check that would include some retro pretty soon. You have to wait for 6 months from the time the SSA concludes you meet disability requirements to get a check. That would have been in July 2008. So they owe you since that date is how I understand it. Did you have a lawyer? If so he gets some of the retro. If not you get it all.
After going through SSDI process I can tell you thier terminology for an approval is " favorable" so you did get SSDI. Yes they go through another review esp with court cases.
Non Medical would be Psy.
You will get a 6 monthds of back pay. If you did direct deposit I would say within 60 days.
A yes, usually has to go before a review also. that can delay it 60 days.
I have SSDI for 2 conditions both medical. They will give SSDI for the conditions that are 100% disabling.
I didn't know this until I got a copy of what I was granted SSDI for, they don't give you anything saying why. You already got the "favoravle" letterr.
Congrats on your win
Non Medical would be Psy.
You will get a 6 monthds of back pay. If you did direct deposit I would say within 60 days.
A yes, usually has to go before a review also. that can delay it 60 days.
I have SSDI for 2 conditions both medical. They will give SSDI for the conditions that are 100% disabling.
I didn't know this until I got a copy of what I was granted SSDI for, they don't give you anything saying why. You already got the "favoravle" letterr.
Congrats on your win
Congratulations, Sounds Good to me!!
Betty
Ruffcreek - congratulations my friend.
I am not a SSDI expert but let me take a whack at your questions:
-Yes it is common for this type of review to occurr. It is called an On the Record (OTR) review. While your file is sitting there gathering dust waiting for the ALJ hearing, your attorney should (if he/she don't them fire them) ask the SS Office to conduct a OTR review of your claim. This is done due to the fact that after the denial and while getting ready for the hearing, most of the time new evidence is developed and added to the file. Just think of it in VA terms as a DRO review. The request from your attorney will indicate that either 1. the evidence in the file warrants nothing more than an approval or 2. since the denial new evidence has been developed and added to the file which warrants a definite approval. At that point a senior adjudicator will review the file and if appropriate award the claim. They even do this sometimes without any prompting, because they sit there and watch the files pile up while waiting for the one or two ALJ's to schedule the hearings......would kinda be nice if VA functioned this way!!!!
-Non-medical requirements are simply those basic requirements needed to establish the claim such as do you meet the required number of work quarters to qualify for SSDI, are you really a citizen, do your dependents meet elgibility requirements etc........;
-Normally takes 4-8 weeks depending on the work load of your supporting office.
Hope this helps you a little bit.
-
I am not a SSDI expert but let me take a whack at your questions:
-Yes it is common for this type of review to occurr. It is called an On the Record (OTR) review. While your file is sitting there gathering dust waiting for the ALJ hearing, your attorney should (if he/she don't them fire them) ask the SS Office to conduct a OTR review of your claim. This is done due to the fact that after the denial and while getting ready for the hearing, most of the time new evidence is developed and added to the file. Just think of it in VA terms as a DRO review. The request from your attorney will indicate that either 1. the evidence in the file warrants nothing more than an approval or 2. since the denial new evidence has been developed and added to the file which warrants a definite approval. At that point a senior adjudicator will review the file and if appropriate award the claim. They even do this sometimes without any prompting, because they sit there and watch the files pile up while waiting for the one or two ALJ's to schedule the hearings......would kinda be nice if VA functioned this way!!!!
-Non-medical requirements are simply those basic requirements needed to establish the claim such as do you meet the required number of work quarters to qualify for SSDI, are you really a citizen, do your dependents meet elgibility requirements etc........;
-Normally takes 4-8 weeks depending on the work load of your supporting office.
Hope this helps you a little bit.
-
Congrats you won and they owe you money. I calculate about 8 months worth. The average is about 1000 bucks and in about 16 months you will get Medicare.
Social Security does all kinds of reviews and only tell you when they make a change.
Social Security does all kinds of reviews and only tell you when they make a change.
Thanks everyone for all your comments. I appreciate it and just want mention that I do have an attorney so he will get most of the retro but it was worth it.
Yes-this is normal-you must have asked for Reconsideration or appealed with some good evidence-
I agree that they need to check how much and for how long you paid into the SSA account to develop the proper amount of your check (dependents might get one too if there are children under 16.)
SSA gave my husband SSA for a CVA but we filed for Reconsideration as they never evaluated his PTSD. A few months later they award PTSD,with a better SSA EED and sent us over 17,000 thousand.
The reconsideration only took 3-4 months and the retro check came in 3-4 weeks.
I agree that they need to check how much and for how long you paid into the SSA account to develop the proper amount of your check (dependents might get one too if there are children under 16.)
SSA gave my husband SSA for a CVA but we filed for Reconsideration as they never evaluated his PTSD. A few months later they award PTSD,with a better SSA EED and sent us over 17,000 thousand.
The reconsideration only took 3-4 months and the retro check came in 3-4 weeks.
Talk about fast! I received my Notice of Award this morning. It took only 7 days from the Notice of Decision letter.
Glad to be over with it!
Glad to be over with it!
QUOTE (Berta @ Mar 7 2009, 10:16 AM) 
Yes-this is normal-you must have asked for Reconsideration or appealed with some good evidence-
I agree that they need to check how much and for how long you paid into the SSA account to develop the proper amount of your check (dependents might get one too if there are children under 16.)
SSA gave my husband SSA for a CVA but we filed for Reconsideration as they never evaluated his PTSD. A few months later they award PTSD,with a better SSA EED and sent us over 17,000 thousand.
The reconsideration only took 3-4 months and the retro check came in 3-4 weeks.
I agree that they need to check how much and for how long you paid into the SSA account to develop the proper amount of your check (dependents might get one too if there are children under 16.)
SSA gave my husband SSA for a CVA but we filed for Reconsideration as they never evaluated his PTSD. A few months later they award PTSD,with a better SSA EED and sent us over 17,000 thousand.
The reconsideration only took 3-4 months and the retro check came in 3-4 weeks.
ruffcreek,
congrats on the the award, ms berta do you have a better chance of getting approved for ssdi with ptsd at the alj level.
QUOTE (Ruffcreek @ Mar 6 2009, 11:37 AM)
My claim for SS disability was denied last summer and I appealed and have received notice for my request for a hearing before an ALJ.
Then unexpectedly yesterday I received the following letter from SS. "This determination is based on another review of your claim. As a result of our additional review, we are able to make a fully favorable medical decision and find that you meet the medical requirements for disability benefits. The onset of your disability is established as of January 18, 2008. Therefore, it is not necessary to have your case decided at the hearing level. We have not yet made a decision about whether you meet the nonmedical requirements, but we will make that decision soon. You will soon get a notice about the amount of your payments if you meet the nonmedical requirements."
This seems positive to me but 1) is this normal for them to do another review after I appealed the 1st denial?, 2) what are nonmedical requirements?, and 3) anybody care to guess how SOON the decision will be made?
Thanks to anyone who cares to comment.
The non medical requirements are reference to the quarterly payments you made into SS. That will determine the amount, if any you receive. You are approved for SSD, now they are checking your payments into the system to determine the amount they will pay each month. When I applied I received my approval letter three months later along with the amount of back pay and future monthly payments deposited two weeks later. There is no set time when the payments will start, sadly their incompetence is only bettered by the VA. You will receive it faster if you choose direct deposit. As long as you worked the required quarter's and made the SS payments into the system your checks will be determined by those amounts. If you did not qualify for those two items you will never the less receive Medicare part A in approximately 6 mo. Part B has to be paid for.
Then unexpectedly yesterday I received the following letter from SS. "This determination is based on another review of your claim. As a result of our additional review, we are able to make a fully favorable medical decision and find that you meet the medical requirements for disability benefits. The onset of your disability is established as of January 18, 2008. Therefore, it is not necessary to have your case decided at the hearing level. We have not yet made a decision about whether you meet the nonmedical requirements, but we will make that decision soon. You will soon get a notice about the amount of your payments if you meet the nonmedical requirements."
This seems positive to me but 1) is this normal for them to do another review after I appealed the 1st denial?, 2) what are nonmedical requirements?, and 3) anybody care to guess how SOON the decision will be made?
Thanks to anyone who cares to comment.
The non medical requirements are reference to the quarterly payments you made into SS. That will determine the amount, if any you receive. You are approved for SSD, now they are checking your payments into the system to determine the amount they will pay each month. When I applied I received my approval letter three months later along with the amount of back pay and future monthly payments deposited two weeks later. There is no set time when the payments will start, sadly their incompetence is only bettered by the VA. You will receive it faster if you choose direct deposit. As long as you worked the required quarter's and made the SS payments into the system your checks will be determined by those amounts. If you did not qualify for those two items you will never the less receive Medicare part A in approximately 6 mo. Part B has to be paid for.
Yes. A sizable number of claims are granted by the ALJ.
I read somewhere two things that somewhat explain that:
1. Lower level employees can ONLY go by the POMS manual and black and white guidelines. If you fit EXACTLY into those parameters - they can grant it. Otherwise, they can't.
But an ALJ has much broader power. He can follow the LAW - and INTERPRET reports, etc. etc.
i.e. he is allowed to THINK - and not just connect the dots.
2. Lower level employees do NOT get in trouble for denying claims that should have been granted, but they CAN get in trouble for granting claims that should have been denied. Therefore, they are more prone to error on the side of job security.
I am not sure how true either of these ideas are - but I did read them somewhere - and they made sense (relatively speaking).
Free
I read somewhere two things that somewhat explain that:
1. Lower level employees can ONLY go by the POMS manual and black and white guidelines. If you fit EXACTLY into those parameters - they can grant it. Otherwise, they can't.
But an ALJ has much broader power. He can follow the LAW - and INTERPRET reports, etc. etc.
i.e. he is allowed to THINK - and not just connect the dots.
2. Lower level employees do NOT get in trouble for denying claims that should have been granted, but they CAN get in trouble for granting claims that should have been denied. Therefore, they are more prone to error on the side of job security.
I am not sure how true either of these ideas are - but I did read them somewhere - and they made sense (relatively speaking).
Free
QUOTE (ltate90 @ Mar 8 2009, 08:45 AM)
ruffcreek,
congrats on the the award, ms berta do you have a better chance of getting approved for ssdi with ptsd at the alj level.
congrats on the the award, ms berta do you have a better chance of getting approved for ssdi with ptsd at the alj level.
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