The Initial Application and Reconsideration Process

A claimant can file a claim for benefits by visiting a social security office and filing an application with the help of a claims representative. An applicant can also apply on the internet. In general, applications for (SSDI) or (SSI) will be developed by a State agency adjudicator in Springfield, Illinois.

An adjudicator will obtain medical documentation of disability by contacting a claimant’s doctor(s) and other medical sources (psychologist, physical therapists, mental health social worker, or hospital medical record departments). The claimant’s attorney will often participate in this process by assisting the claimant obtain medical documentation; complete questionnaires related to activities of daily living and relevant work history. A determination regarding eligibility for benefits will be made by the State agency.

If the initial application for benefits is denied, a claimant should immediately consult an experienced attorney about the appeals process. A timely reconsideration of the initial denial is important because the appeals process involves deadlines. At the reconsideration level, a State agency adjudicator will consider the claim again by obtaining additional and more recent medical documentation.

The State agency adjudicator may arrange for the claimant to undergo an examination by a doctor. If the claim is denied again, the law provides the claimant with a right to a hearing before an administrative law judge.

The Administrative Hearing and Beyond

At this point, it is understandable if a claimant is angry and confused after receiving initial and reconsideration denial determinations. Agustin is ready, willing and committed to share his insights about this process with his clients.

Generally, the hearing lasts about an hour and during this time, a claimant will testify and the attorney will reference relevant medical evidence and regulations in order to establish disability. Furthermore, a vocational expert may be asked by the administrative law judge to testify about the claimant’s past work and related skills. And a doctor may also be asked to give testimony about the claimant’s medical conditions and related functional limitations, if any.

The claimant’s attorney will be given an opportunity to question each expert. This evidence along with other medical documentation, including the claimant’s testimony will provide the basis for the Administrative Law Judge’s decision. Hopefully, the decision will be favorable.

Agustin has over 30 years of comprehensive administrative law and litigation experience. During this period, he has successfully represented thousands of claimants obtain benefits and he is an effective advocate for the social security disability claimant.