If you suffer in medical problems that result in your inability to work, you may be able to get Social Security Disability benefits. The Social Security Administration (SSA) oversees two disability programs that provide monthly benefits to disabled workers.
To be approved for benefits, you must meet specific medical criteria and your condition must either be expected to result in your death or last a year or longer. The Blue Book is the medical guide that is used by the SSA to determine eligibility and each listing has a specific criteria that needs to be met.
Most disability claims are denied. If your claim is denied during the initial review, you can file an appeal to request a reconsideration. If your claim is denied again during the reconsideration review, you can ask for an appeal hearing before an administrative law judge (ALJ).
Disability claims are denied for hundreds of reasons, but there are some very common reasons for claim denials. If you are continuing to work but your income exceeds the limits for substantial gainful activity (SGA), your claim will not be approved because it will be determined you can work enough to earn a living.
If you have a diagnosis but fail to continue with follow-up care, your claim will be denied because it cannot be determined if your condition has improved and if you are disabled. Hard medical evidence is required to assess a claim and determine if an individual is disabled.
If you cannot provide hard medical evidence to Disability Determination Services (DDS) and the SSA, your claim will be denied. In Pennsylvania, about 32% of claims are approved during the initial review while only 20.7% are approved during the reconsideration review.
Visiting the ORAR in Pennsylvania
If your claim is denied during the initial review and the reconsideration review, you will once again appeal and call for a hearing before an ALJ. Hearings are held at the ODAR . At the hearing, you will be questioned by the ALJ.
The ALJ will go over your documentation and medical records. You will be asked about how your daily activities are affected, your limitations and restrictions, and how your medical problems keep you from working.
At the hearing, a vocational expert will be in attendance. The vocational expert will also ask you about your work history, educational background, work skills, and medical restrictions to determine if you can do any kind of work.
There are eight ODARs in Pennsylvania. The average wait for a hearing in the state is 20.7 months. In Pennsylvania, it takes an average 673 days for a claim to be processed. In the state, there are 40% of claims approved at the hearing level compared to 43% on the national level.
Wilkes Barre ODAR has 13 judges and a 19-month wait for a hearing. At that ODAR, 40% of claims are approved. At the Pittsburgh ODAR, there are 12 judges and a 21-month wait for a hearing.
That ODAR has a 36% approval rate. The Elkins Park ODAR has 15 judges and a 20.5-month wait. That office has as 41% approval rate. A disability attorney will help you get ready for your hearing and prepare you for questioning.
Seek the Counsel of a Social Security Attorney
If you have found yourself unable to work because of medical problems, you should consult with a lawyer. An attorney can file the initial claim, handle all correspondence and communication with the SSA and DDS, and will go through your file to make sure all your medical records and documentation are in order and ready for review.
Your attorney will visit DDS and the local SSA Office if necessary to check your file and will represent you at the hearing level. There are multiple SSA offices in the State of Pennsylvania.
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Social Security Administration
201 Penn Street #200
Reading, PA 19601 -
Social Security Administration
2373 Welsh Road
Philadelphia, PA 19114 -
Social Security Administration
6117 Station Street
Pittsburgh, PA 15206
Complete the Free Case Evaluation Form on this page to get your details shared with a disability lawyer. You will get a free case review and it will be determined how to proceed with your claim.
