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A new process for disability determination and appeals of unfavorable decisions was implemented in the summer of 2006 in the Social Security Administration's Boston Region, which encompasses Connecticut, Massachusetts, Maine, New Hampshire, Rhode Island, and Vermont. If you have applied for SSDI or SSI in one of these states, the new process will apply to your case. If you applied outside the Boston Region, the "old" disability determination and appeals process applies to your case.
Based on the New Electronic Disability Claims System
The new process is based on the SSA's electronic disability claims system. Computerizing the whole system is helping reduce the case backlog and the amount of time that people must wait for decisions about their cases. The new process is significantly different from the existing process.
Components of the New Disability Determination Process
The new process is in place in the Boston Region, and is expected to be implemented eventually in all of the regions of the U.S. Here are its components:
(1) A Quick Disability Determination (QDD) process for the cases of people who are obviously disabled. This computerized process identifies cases that are most likely to be given a favorable decision. In the Boston Region, 97% of the cases examined in the QDD process have been decided within the required 21 days, with an average decision time of 11 days. About 85% of these cases received a favorable benefits decision during the initial review, and more cases received a favorable decision when additional documentation was supplied by the applicants. Most of the cases so far have involved cancer, but the QDD model is being expanded to identify more types of clear disability.
(2) A Medical-Vocational Expert System (MVES) has been put in place to provide more of the medical and vocational expertise that's needed to make accurate and timely benefits decisions. The MVES is made up of a Medical-Vocational Expert Unit and a nationwide network of medical, psychological, and vocational experts. Their helps move the disability determination process along.
(3) Federal Reviewing Officials (FedROs) now review unfavorable state agency decisions when a claimant requests it. This eliminates the Reconsideration step of the existing appeals process.
(4) If a claimant disagrees with the decision of the Federal Reviewing Official, he or she has the right to request a "de novo" (new) hearing and decision from an Administrative Law Judge.
(5) A claimant's record is closed after the Administrative Law Judge issues a decision, but there are certain "good cause" exceptions to this rule.
(6) A Decision Review Board reviews and corrects decision errors and makes sure that there is consistent adjudication at all levels of the disability determination process. The Appeals Council component of the "old" process isn't used in the new process.
For Help with the New Process
If you have any questions or concerns about the new disability determinations process, you can contact the Boston Region's office at 1-800-772-1213 or visit their website at http://www.ssa.gov/boston/. An experienced SSDI/SSI attorney can also be of great assistance — contact an attorney today for help with your disability case.
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