Can you please explain how SSA actually considers a claim? What things do they actually evaluate when a claim is filed? How long does it take to receive an answer?

SSA evaluates a claim through a procedure known as "Sequential Analysis". The questions that the claims adjudicator must ask and answer are as follows: 1) Is there a medically determinable impairment? 2) Is the impairment severe? 3) Will the impairment last 12 months? 4) Does the impairment meet or equal the listings? 5) Can claimant do his or her past work? 6) Can claimant do other types of work?

With regard to question #4, whether or not an impairment meets or equals the listings, is a process by which the claims adjudicator or staff physician compare medical signs, symptoms and lab findings to a predetermined list of signs, symptoms and lab findings found in the official medical listings resource used by SSA.

In order to receive an award of benefits, the claims adjudicator must answer questions #1-4 "yes" and questions #5 and 6 "no". In order to be successful with an award, the claims adjudicator must find that a claimant cannot perform past work as well as perform any other work.

The time it takes for a claim to be processed and decided varies depending upon the amount of claims that a given adjudicator is responsible for processing. It also depends upon how long it takes to request and receive the medical and vocational evidence that is required to make a determination or how quickly medical examinations can be scheduled and conducted. On average, it can take approximately 3-6 months to receive an answer from SSA on your initial claim, however, it can take less time or more time, depending upon many variables.

Post edited by: moderator, at: 2004/09/08 03:26