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 - Approximately seven out of ten claims for disability in Florida are denied at the initial claim, or disability application, level in Florida. Because the prospect of being denied on a disability claim in Florida is so high, most claimants can expect to utilize the appeal process before they eventually receive disability benefits.
Applying for disability in Florida will involve having to complete a disability application interview with a claims representative in a local office.
The purpose of the interview is to provide the claims representative with all the information that may be necessary for properly evaluating the claim, and, potentially, meeting the qualifications necessary for receiving a Social Security Disability award or SSI disability award.
Qualifying for disability in Florida
Individuals filing for disability in Florida should keep in mind that while their cases will be decided primarily on the basis of information contained in their medical records, the decision will also be made using vocational information (i.e. information concerning one's job history) if they are an adult, and often academic information if they are a minor-age child on whose behalf the claim is being filed.
For adults applying for disability benefits, the goal will be establish that one's current and projected functional limitations(physical limitations or mental limitations) are severe enough to prevent the individual from engaging in their past work activity, or in other types of work activity at a level that earns them a substantial and gainful income.
Whether or not a claim for disability is considered to meet the qualications and requirements for disability will depend on the findings reached by a disability examiner.
A disability examiner is not the same individual who take claims in Social Security offices. Examiners work at state disability agencies (usually, depending on the state, referred to as DDS, disability determination services, or DDD, the disability determination division. The examiner who handles the disability determination for a claim will have the claim forwarded to them after the initial intake phase has been completed at a Social Security field office.
The examiner's chief goal is to gather records from the doctors and other sources of medical treatment listed on the disability application. The examiner then extracts the pertinent information from those records in order to determine if the claimant's case satisfies the SSA definition of disability, thereby qualifying the claimant to receive disability benefits under either the title II SSD or title 16 SSI program.
As stated above, the majority of claims will be denied at the initial claim level and individuals wishing to pursue their claim should file their first appeal, which is a request for reconsideration. Claimants who follow the appeal process will, statistically, be likely to have benefits approved by the time the second appeal, a hearing before an administrative law judge, takes place.
Filing for disability claim as a child
For children applying for disability in Florida, the disability qualifications are a bit different. The requirements for disability for children are predicated on the inability to engage in activities that would be considered normal for one's age, i.e. age-appropriate activities.
It is for this reason that on children's claims medical records are reviewed, but school records are also often reviewed when the child is of school age (including grade reports, IEPs, and reports of academic and intellectual testing).
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WHAT YOU NEED TO KNOW BEFORE YOU APPLY
AVOID MISTAKES W/FREE HELP!
WHAT YOU NEED TO KNOW BEFORE YOU APPLY
The denial rate in Florida is quite high at 73%, one big reason for this is that many people do not get representation until they have been denied.
Many lawyers are partly to blame for this since it is very common for someone looking for a lawyer at application level for their SSDI or SSI claim to be told to "apply and call back when you are denied". Some lawyers(not all) do this because an attorney's fee is based on past due benefits and if the lawyer wins a case at application they feel the fee does not cover the work involved in handling a case at this level.
This approach should be avoided because it is very important that the case be handled properly from the beginning, not only to assure you have the best chance to win at application, but also to ensure that an application that was not properly done does not come back to haunt you at a later stage in the process. Approval rates are much higher at the initial application level.
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