For more than 20 years, the procedure in a Social Security case in Pennsylvania was for a disabled individual to file an application, have the case decided by the Bureau of Disability Determination, and if the case was denied, file a request for a hearing before a Judge. If the individual filed the Request for Hearing within 60 days after the denial, the individual had the right to have the case decided by an Administrative Law Judge after a hearing.

The Social Security Administrative Law Judge would hold a hearing, listen to the individual’s testimony about his/her medical conditions, review the medical evidence, and make a decision about the disability case. The Judge would issue a favorable decision or deny the claim (unfavorable decision). According to recent a recent government report, based on nationwide data, an Administrative Law Judge would award benefits about 53% of the time after a hearing.

Recently, the Social Security Administration announced changes to its procedure for processing Social Security Claims in Pennsylvania. Beginning April 1, 2019, if an individual receives a denial on a Social Security Disability application, a “Request for Reconsideration,” and not a Request for Hearing, must be filed within 60 days of receipt of the denial.   This means that now, a disabled individual must go through an additional step which involves the Bureau of Disability Determination reviewing the disabled person’s claim a second time.

This change in procedure is a cause for concern among advocates for disabled individuals.  Reconsideration is commonly viewed as another obstacle in the way of an individual obtaining Social Security Disability Benefits. The problem is that during Reconsideration, the same process, and the same agency, is used to make a decision on the disability claim. For example, during the application phase, the Bureau of Disability may send an individual to a doctor of its choosing, rather than ask the disabled individual’s treating physician for more information about the individual’s medical condition.  Once the initial application for disability is denied, and the Bureau of Disability Determination is asked to reconsider its decision, it may not obtain new medical information on the disabled individual’s claim. Studies indicate that almost 90% of the time, during the Reconsideration procedure, the disability claim will be denied again. Only after the Request for Reconsideration is denied, will the individual be able to request a hearing. By that time, an estimated 100 days has been added to the disabled individual’s wait time for benefits.

To get a Social Security Disability claim in the best possible posture, and to eliminate wait time, it is best to have an attorney represent you from the very beginning of the case. Contact the Attorney Linda F. Gerencser for a free consultation.

~Linda F. Gerencser

Posted in News on by Pyfer Reese.