Your Social Security Claim through the System
Jacques Chambers, CLU, Benefits Consultant
majority of people who file for Social Security Disability
benefits, either SSDI or SSI, complete the requested
paperwork, submit it—then they wait. Sometimes for months
without hearing a word. Not following up on the claim and
tracking it through the system may be one reason over half of
the disability applications are denied the first time around.
you have submitted your initial paperwork, there is a lot you
can do that will improve the chances of an approval. In
addition to making sure your claim doesn’t get lost or
sidetracked, tracking your claim allows you to make sure that
they receive every piece of information they need to approve
understand that the Social Security Administration is not
“out to deny your claim.” The people that decide whether
or not you qualify for benefits would just as soon approve
your claim as deny it. It’s not their money; they’re happy
for you to get it. The problem they have is the small amount
of time they can spend on each claim.
people reviewing disability claims work in a huge bureaucracy.
That bureaucracy, in its attempt to decide claims in the same
manner in all offices, requires that specific information and
documents must be in the file before a claim can be approved.
A Claims Service Representative or a Claims Analyst’s
performance is measured by how quickly and thoroughly they can
complete and close their claim files.
workload is such that they can’t follow up and track down
everything they need or have requested. If they don’t have
enough information to approve your claim and if they do not
receive the medical records they need after a few requests,
they will simply deny the claim. You can prevent that by
staying in touch with the people handling your claim. They
will appreciate any help you can give them.
first step is to take all the necessary information and
documents needed to the initial interview. You can obtain a
list of what you will need at www.ssa.gov,
at other websites, from Social Security literature, or from
the telephone clerk who schedules your initial appointment.
person you meet with at the initial interview is not the
person who will be reviewing your medical records. Once a
disability file is opened at Social Security, they will send
your file to the local state office that examines all
disability claims is your state and determines if you meet
Social Security’s definition of disability. A Claims Analyst
in that office will be assigned to your claim and will order
the medical records from your doctors, send you and your
doctors questionnaires to complete, decide whether you need to
see a Social Security doctor, and finally decide whether or
not you are eligible for benefits. You can provide invaluable
help to the Analyst through the process.
you have your initial interview, ask the Claims Representative
how long it will take to assign a Claims Analyst. This will
vary by office and can be anywhere from two or three days to
two or three weeks. Ask for the phone number you can call to
find the name of the Claims Analyst once your file is
assigned. Following the timeline recommended by the
Social Security Representative, call the number and get the
name and phone number of Analyst assigned to your claim.
the Analyst. Introduce yourself. Usually she will need your
name and Social Security number to locate your file. Ask her
for the Case or File Number. This is an internal number that
the Disability Evaluations Department assigns to each
application. Using that number during future calls will help
the Analyst find your file faster.
know (the Analyst may be a “he” but most are women) that
you are calling simply to offer your help in obtaining all the
information needed to make a determination.
talking to the Analyst (or the Social Security
Representative), stay helpful and empathetic to her workload.
While you want to make each contact as pleasant as possible,
don’t expect her to have the time to “visit” with you.
Keep your contact brief and to the point.
way to avoid calling too often and becoming a “pest” is,
at the end of each conversation, tell the Analyst, “I
don’t want to bother you but I want to stay on top of my
claim. When would be a good time to check back with you? In a
week?” That lets the Analyst stay “in control” of your
contacts. She won’t feel so intruded upon if you call back
after an interval that she has already agreed to.
remember that your contacts are to help the Analyst perform
her job. Trying to persuade her to approve your claim is no
help. Focus on getting her what she needs to decide your
claim. And arguing with her is downright harmful. In fact, if
you end up in a conflict with the Analyst, I encourage you to
hire an attorney or advocate to deal with her directly. That
will get things off to a fresh start.
the first phone call, ask her if she has had a chance to look
at your file to see what medical records she will need to
obtain. It is entirely possible that she has not. Ask her to
let you know when she sends out requests (if she hasn’t
already) for medical records. Ask her to send you copies of
the requests so you can follow up with each doctor to make
sure the records are sent promptly.
you know which doctors she is sending requests to, you should
contact each doctor’s office, advise the office staff that
the request is coming, and ask them to send the information as
quickly as possible. If the staff is busy, you or your spouse
may even want to offer to come in and do the photocopying of
the medical record for them.
you have the date that the records were sent to the Analyst,
allow for mail time, then call the Analyst to make sure she
got them. You may have to go back and forth between the
various doctors and the Analyst several times. Do not be
impatient, and don’t blame either the Analyst or the office
staff. Be patient and persistent. Just keep calling and asking
and checking. In other words, do everything possible to see
that the requested records get to the Analyst. If necessary,
go to the doctor’s office, photocopy the records yourself
and send them registered to the Analyst.
Analyst sends you a questionnaire to complete, it is usually
due back within ten days. However, if you call the Analyst,
she will always allow you extra time to complete and submit
Analyst wants you to see a Social Security doctor, call her
and ask if your own doctor can perform the examination. They
will approve that most of the time provided your doctor agrees
and is willing to accept Social Security’s fee.
are some things that an Analyst will not do, however, so it is
better not to ask. They will not help you fill out the
questionnaires they send. Those are for you and your advocate
to do. Also, they are not allowed to tell you whether your
claim has been approved or denied. As long as the Analyst
wants more information, you know that there is not yet enough
information in your file to approve your claim, but she is
willing to approve it if she can obtain the documentation she
as you are willing to continue to provide information, whether
it is medical records, physician statements, additional
diagnostic examinations, or statements from third party
friends or family, most Analysts will keep your file open as
long as they know you are working to provide additional
the Analyst states that all the necessary information is in,
there is nothing more she can tell you. You need to direct
further questions back to your local Social Security office.
However, you may get a clue to the decision by what happens
next. The Analyst sends out the denial letters, but
acceptances must be sent from the Social Security
Administration. So once all the information is in, if you
don’t receive a denial fairly quickly, that’s a good sign.
a claim is sent to the Regional Headquarters for a “quality
review,” before being returned to the SSA office. The good
news there is most claims sent for qualify review are approved
final note, some Analysts never answer their phones and rely
on voicemail for client contact or only take calls at certain
times. Don’t let that deter you. Conduct your business by
voicemail, just as if you are talking to her. Offer to help;
ask for the doctors she is contacting; offer to follow up. It
is the rare Analyst that won’t take advantage of your offer.
Your assistance makes it easier for her to do her job.
Chambers, CLU, and his company, Chambers Benefits Consulting,
have over 35 years of experience in health, life and
disability insurance and Social Security disability benefits.
For the past twelve years, he has been assisting people with
their rights, problems, and other issues concerning benefits
and disability. He can be reached at firstname.lastname@example.org
or through his website at: http://www.helpwithbenefits.com.]
Copyright July 2003 – Hepatitis C Support Project - All
Rights Reserved. Permission to reprint is granted and
encouraged with credit to the Hepatitis C Support Project.