If you have health issues that have resulted in you being unable to work, you might be eligible to receive disability benefits from the Social Security Administration (SSA). The SSA oversees two different disability benefit programs that help disabled workers cover their living expenses.
To be approved for benefits, your medical condition must last at least a year or it must lead to your death. There are specific medical criteria that must be met. Those medical criteria are specified in the medical guide, which is called the Blue Book.
Most disability claims are denied, so an appeal can be filed. When you file an appeal, your claim will go to reconsideration review. If your claim is once again denied at that level, you will file another appeal and request a hearing. Your hearing will go before an administrative law judge (ALJ) for a decision.
Claims are denied for various kinds of reasons. Some reasons are common causes for claims being denied. Usually, claims are denied because there is a lack of hard medical evidence. Medical evidence must include physician notes, surgical reports, lab results, x-ray and scan reports, prescription records and treatment records.
Disability Determination Services (DDS) must be able to understand the severity of your condition as well as limitations or restrictions you suffer because of your condition.
Other causes for claim denials include failing to seek follow-up care so DDS cannot determine if your condition improved enough for you to return to work and working enough to earn more than the limits for substantial gainful activity (SGA). In New York, 44% of claims are approved on the initial review and there is a 51% approval rate for reconsiderations.
Visiting the Office of Disability Adjudication and Review in New York
If your claim is denied during the initial review, then denied again during the reconsideration review, you can file an appeal to request a hearing before an ALJ. Hearings are held at the Office of Disability Adjudication and Review (ODAR).
During the hearing, you will be questioned about your condition and your limitations and restrictions. You will be questioned by the ALJ and by a vocational expert. Your Social Security lawyer can help you prepare for questioning and get your claim on track.
Your work history, transferrable skills, educational level, and medical conditions are all considered to determine if you can perform any kind of work. In New York, 43% of claims are approved on the hearing level.
There is an average 21.8-month wait for a hearing date and it takes an average of 700 days to process a claim. There is a 48% approval rate for hearings in New York.
New York has 10 ODARs. The Albany ODAR has 13 judges and an average 18-month wait for a hearing date. At that office, 51% of claims are approved. The Buffalo ODAR has 14 judges and a 24-month wait for a hearing date. At Buffalo, 36% of claims are approved.
There are four judges at the Rochester ODAR where there is a 22.5-month wait for a hearing. That branch has a 56% approval rate. Those who have an attorney have much greater odds of having their claim approved. An attorney can help you prepare for the hearing and the questioning aspect as well.
Getting Help From A Disability Attorney
Because disability claims are so complicated, you need to enlist the help of a lawyer. A lawyer can help you throughout the entire claims process. Your attorney can help you file your claim and handle all communications with the SSA office.
Your attorney can go with you to DDS or the local SSA office and make sure they have all access to your medical files so they can fairly assess your situation and determine if you are disabled. There are several SSA offices in New York. Here are some of those offices.
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Social Security Administration
237 West 48th Street, 5th Floor
New York, NY 10036 -
Social Security Administration
195 Montague Street
Brooklyn, NY 11201 -
Social Security Administration
2501 Grand Concourse
Bronx, NY 10468
To get your claim started, complete the Free Case Evaluation Form on this page. Your details will be shared with a Social Security attorney, so you can get a free review of your claim.
