Applying for Disability in KentuckyHow to apply and qualify for SSD, SSI in Kentucky Note: If you have already filed a claim and been denied for disability, or are wondering what to do in the event of a Social Security denial, proceed to the reconsideration and hearing appeal sections below. Level I: Disability Application - A fairly reliable statistic is that, in a typical year, approximately 30 percent of all initial claims (disabiilty applications) will be approved. The corollary to this is that as much as 70 percent of all disability back pay (back pay generally occurs due to how long disability cases take to be processed). Filing for disability in Kentucky The disability application process should begin with a call to a local Social Security office. As opposed to filing online, when claims are handled with a local office, the claimant will have the opportunity to ask questions to the SSA field office claims representative (CR) and receive direct answers. Additionally, the online filing process does not allow for an SSI disability claim to be taken (which is an impediment since claimants will not know in advance if their claim will involve SSD, SSI, or both SSD and SSI in the form of a concurrent claim). After contact is made with a local Social Security office, an appointment will be set for a disability application interview. Claimants may wish to write down both their medical and work histories in advance of this appointment so that the interview goes more smoothly and so that critical information is not left out. Note: Claimants who have physical mobility or transportation problems can ordinarily arrange to have their disability interview conducted over the phone. This may also be requested for claimants who simply prefer a phone interview. Social Security Disability and SSI approvals Disability approval decisions are made in two separate ways. The first is by rendering a disability award on the basis of satisfying the requirements of a listing in the Social Security list of impairments, otherwise known as the listing manual. When approvals are made this way, they will be made on the basis of the medical evidence alone. Qualifying for disability on the basis of a listing will mean that the claimant's records have demonstrated that they have a medical condition that clearly satisfies the approval criteria of a condition contained in the listings. Note: the majority of approvals are not made in this manner since listing requirements are usually very specific and difficult to meet. The second route to an approval is by being awarded via a medical vocational allowance. In this type of approval, both the medical evidence and the claimant's work history are examined. The claimant's current functional limitations are ascertained from the medical records and are compared to the claimant's past work demand levels and skill levels to determine if they have the capacity to either a) return to their past work or b) switch to some type of other work. If the claimant cannot return to work activity at a substantial and gainful activity, or SGA, level, they may meet the requirements and qualifications to receive disability benefits. Individuals who are approved may look forward to receiving a notice of award and an explanation of their continuing monthly benefits, as well as whatever back pay they may be eligible to receive. Those who have been denied should immediately file an appeal within the allotted time period (60 days from the date of the denial), in addition to considering the prospect of locating a disability representative (who may be a disability lawyer or a non-attorney disability representative) to assist them with their claim, if they are not already represented. The process to qualify for disability in Kentucky Social Security Disability and SSI claims in Kentucky follow a two-step process. The claim for disability begins at a local Social Security office. At a field office, a claimant is given a disability application interview. The purpose of this interview is to learn about the claimant's medical treatment sources and past work history. This information will form the basis for whatever decision is made. After the interview has been conducted and the claim has been sent to the disability processing agency in the state (a DDS or disability determination services agency), it is assigned to a disability examiner. The examiner's first task will be to gather all the information that is needed to make a decision on the claim. As soon as the claim is received from the Social Security office, the examiner will begin generating MER (medical evidence of record) request letters that will be sent to each doctor, hospital, and clinic listed by the claimant at the time of applying for disability. In situations where the claimant has not listed the correct name or address of the medical treatment source, the examiner may be able to obtain this information from a medical source database. However, this is not always possible (particularly if the claimant has listed an absolutely incorrect name). It goes without saying that not being able to obtain all of the necessary records can have a detrimental effect on the outcome of the claim (i.e. the claim may be denied, or the claim may be approved but with a less favorable date of onset, which would mean potentially less back pay received by the claimant). It is imperative that the individual filing for disability in Kentucky provide complete and detailed information at the time of application in order to maximize the chances of winning benefits. The qualifications for disability are based on satisfying the Social Security Administration's unique definition of disability. To meet the requirments for disability under this definition, a claimant's medical records must verify that they have a severe condition (or several conditions) that will be disabling for at least one full year. By disabling, the Social Security Administration means that the condition must be severe enough to prevent the claimant from being able to work and earn a substantial and gainful income. If a claimant has a condition that does not last for one year, or the claimant's condition lasts for a full year but during that time they work and earn a substantial income, they will not qualify for disability benefits. Their claim, in fact, may be denied by the Social Security office before it is even assigned to a disability examiner. As stated, the majority of claims are denied at the application for disability level. However, the second appeal level, the Social Security hearing, affords the majority of claimants a chance to win their benefits. Cases tend to have a likelier chance of approval when a prepared case that exhibits a rationale for approval is presented to an administrative law judge. Representation also maximizes this, particularly in cases where the judge has expert vocational and medical witnesses appearing to provide testimony on the case (in such cases, the disability lawyer or non-attorney representative may respond to hypothetical scenarios or cross-examine the witnesses).
Level II: Request for Reconsideration - The request for reconsideration is the first appeal available to individuals who have received a denial on a disability application. The appeal must be requested within 60 days of the date stamped on the notice of denial (notice of disapproved claim). As with the initial claim, this appeal is processed by a disability examiner at the state-level disability determination services agency that adjudicates claims for the Social Security Administration. Note: claimants who submit reconsideration appeal paperwork should make a followup status call to their Social Security office within 10-14 days. This will allow the Social Security office to verify that the submitted paperwork was received and eliminate the possibility of a late appeal. When appeals are not submitted in a timely fashion, a claimant may be required to start over with a new claim, losing processing time and, potentially, disability back pay. The qualifications for disability under the reconsideration process are the same. Under reconsideration, a claimant may be denied once more, or they may be approved on the basis of satisfying the requirements of a listing in the impairment listings manual, or approved on the basis of a medical vocational allowance. Most claims that are approved, of course, will not meet the requirements of a listing but, instead, will be granted through a medical vocational allowance. This is the standard decision process in which a disability examiner reviews the medical records, determines the claimant's functional limitations (physically, mentally, or both) and then determines if they retain the ability to go back to their past work. Knowledge of a claimant's past work is critical to the determination process since the requirements of the claimant's past work will be compared to their residual (remaining) functional capacity. However, this information is obtained solely from the person filing for disability; therefore, individuals pursuing disability benefits should provide very accurate descriptions of their past work so that Social Security will not assume that the claimant has higher skills than they actually possess. Individuals who are found to be unable to return to their past work may be approved at the reconsideration appeal level, but only if the disability examiner further finds that they lack the necessary skills and education to switch to some other type of work. Again, this illustrates the importance of providing accurate and detailed work history information. Historically, the majority of claims have been denied at the reconsideration appeal level, as the high rate of denial over the past twenty years illustrates. Statistically, individuals who file their second appeal, a request for an administrative law judge hearing, have a much higher chance of approval.
Level III: Request for Hearing before an Administrative Law Judge - The disability hearing is the second Social Security appeal available to claimants and may be requested only after a reconsideration appeal has been denied. Like all appeals, the hearing must be requested within 60 days of the date of the prior denial, but, ideally, should be requested immediately after receiving notification of the denial of the reconsideration appeal to avoid unnecessary case processing delays, as well as the possibility of a missed appeal deadline. Basic facts about disability hearings
Note: There are multiple hearing offices in Kentucky. The figures quoted above are averages for the state. The individual Kentucky hearing offices approve claims as little as 46.5 percent of the time, and as much as 63 percent of the time according to federal statistics. The Lexington KY hearing office has a disability award rate of 61.4 percent; the Louisville KY hearing office has a disability award rate of 48.3 percent; the Middlesboro KY hearing office has a disability award rate of 46.5 percent; the Paducah KY hearing office has a disability award rate of 63 percent. About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here. Most popular topics on SSDRC.com Social Security Disability in North Carolina Common Mistakes to avoid after being denied for Disability Tips to Prepare for Filing for Social Security Disability or SSI Advice to Win SSD and SSI Benefit Claims Social Security Disability SSI Questions What is the difference between Social Security Disability and SSI? How to get disability for depression Getting disability for fibromyalgia SSI disability for children with ADHD What is the Application Process for Social Security Disability and SSI? Social Security Disability SSI Exam tips More Social Security Disability SSI Questions What makes you eligible for Social Security Disability or SSI? Individual Questions and Answers |
