If you are unable to work because of health problems, you might be eligible to receive Social Security disability benefits. The Social Security Administration (SSA) oversees two disability programs that provide monthly benefits to disabled workers. To qualify for disability benefits, you must meet specific criteria that show you are disabled per SSA guidelines.
A medical guide, which is called the Blue Book, is used to determine disability. Your condition must last at least a year or longer or must be going to lead to your death. Your condition must also meet the specific criteria established in the Blue Book. Most claims are denied, but an appeal can be filed to request reconsideration. If a reconsideration review leads to another denial, you can request a hearing before an administrative law judge (ALJ).
There are dozens of reasons for claims to be denied, but there are some reasons that are more common than others. For example, if you are working and earning more than the limits for substantial gainful activity (SGA), you are not eligible for disability benefits because you are not considered disabled. If you have failed to continue with follow-up medical care, then Disability Determination Services (DDS) cannot determine if your condition is serious enough that the problem is ongoing on worsening, so your claim cannot be approved.
Hard medical evidence that shows the severity of your condition, your limitations, and your restrictions must be provided so DDS can see the true picture of your condition and your abilities or disabilities. In Missouri, about 30.5% of initial claims for disability are approved while 21% are approved during the reconsideration review. When the claims reach the hearing level in Missouri, 44.2% of claims are approved.
Visiting the Office of Disability Adjudication and Review in Missouri
When a disability claim is denied, you should file an appeal instead of starting a new claim. When you do this, your claim will go to reconsideration review. If your claim is denied during reconsideration, you will file an appeal to request a hearing before an ALJ at the Office of Disability Adjudication and Review (ODAR). At the hearing, you will be questioned by the ALJ and a vocational expert. You will be asked about your medical problems and any restrictions or limitations that you have because of them. These questions will be specific to your condition.
The goal is to determine what kind of work, if any, you can perform. Missouri is served by six ODARs. The state average for disability claims involves a 19.5-month wait for a hearing date, 631 days for processing a claim, and a 40% overall approval rate for claims at the hearing level.
The Columbia ODAR has seven judges and an average 19-month wait for a hearing. At Columbia, about 42% of cases are approved. In Kansas City, there are 13 judges and an average 20-month hearing wait. There 41% of claims get approved on the hearing level. The larger NHC St. Louis branch has 27 judges and a 22-month average wait for a hearing date. That office has a 43% approval rate on claims at the hearing level. The Springfield office has 10 judges and an average 17-month wait for a hearing. It usually averages 580 days for claims processing and only 29% of claims are approved at that office on the hearing level.
Your attorney will help you prepare for the hearing by preparing all your records and documentation, and by prepping you for questioning at the hearing.
Getting Help from an Attorney
Because of the complicated design of disability claims and the high number of claims that are denied, you should seek the guidance of a Social Security attorney. Your attorney will handle the communications with the DDS and SSA representatives.
Also, your lawyer can accompany you to the DDS office or the local SSA office to review your file and to make sure all your hard medical evidence and documentation is in order and available. Your lawyer will file any necessary appeals as well and represent you at the hearing. There are several Missouri SSA offices:
Social Security Administration
2445 Cape Center Drive
Cape Girardeau, MO 63703
Monday, Tuesday, Thursday, and Friday 9 a.m. – 4 p.m.; Wednesday, 9 a.m. – 12 p.m.
Social Security Administration
650 Gravois Bluffs
Fenton, MO 63026
Monday, Tuesday, Thursday, and Friday 9 a.m. – 4 p.m.; Wednesday, 9 a.m. – 12 p.m.
Social Security Administration
4102 S Arizona Avenue
Joplin, MO 64804
Monday, Tuesday, Thursday, and Friday 9 a.m. – 4 p.m.; Wednesday, 9 a.m. – 12 p.m.
To get your claim started, go online to the SSA website, call 800-772-1213, or visit your local SSA office. Complete the Free Case Evaluation Form on this page to get your details shared with a local Social Security attorney for a free case review!
