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Demystifying the Social Security disability benefits process: Jim Jirousek (Opinion)

January 18, 2018 GMT

Demystifying the Social Security disability benefits process: Jim Jirousek (Opinion)

SEVEN HILLS, Ohio -- There has been recent interest in the Social Security Disability Benefit Program. As a retired longtime Social Security field representative, I can provide some background information.

New claimants may find the claims process to be a challenging and daunting experience and perhaps approach it with some fear and dread.

I am no longer there to be of direct help, although I am sure today’s staff members in our offices are there to offer assistance to those seeking benefit payments after running into health problems that have forced them to stop working.

Drawing on my nearly 40 years’ experience with the agency, I would like to put things into perspective, provide some background, and perhaps offer some meaningful and worthwhile advice.

Let’s begin by pointing out that Disability is actually the third monthly benefit category under the Social Security system, following Retirement Benefits established with the original Social Security Act of 1935, part of the “New Deal” legislation passed during the administration of President Franklin D. Roosevelt as the country was emerging from the Great Depression. Survivor’s Benefits were added in 1939. Disability came along later, in 1956, and as you are working and paying into the system through FICA taxes (Federal Insurance Contributions Act), you are building insurance protection under all three.

The start of Disability was before my time, but as my forerunners as Cleveland-Downtown District field representatives recalled, this was the toughest time in their careers. Many people with severe, advanced, deteriorating conditions became eligible for the new benefits but were homebound and unable to come into an office to file. The field unit was deluged with requests for house calls. One of the old field representatives described those times as “going out there day after day, going from house to house, seeing people who were dying right before your eyes!” They would come home after another such day and their wives would tell them they had to quit the job. They didn’t. If they had, there would have been no one to go out and take the claims from these severely ill, homebound people.

As many disability claims as there have been, no two are exactly alike in all respects. Each is a unique case, involving a determination as to whether this particular individual has become no longer able to work at a job he or she would be otherwise capable and qualified to do, considering the nature, degree, and extent of the health condition or combination of conditions, along with age, educational background, and lifetime previous work history and experience.

In this computer age, some may think the best way to file a claim is online. I disagree. The best way is to phone in and set up an appointment for a face-to-face interview in an office with a claims representative. First, the claims rep is a skilled, knowledgeable professional, trained and experienced at the proper completion of a claim. Secondly, the claims rep sees the claimant and can make observations about the appearances and symptoms of the claimant’s condition, which could be significant in the decision process. You do not get this through a computer or telephone.

Although you can have a lawyer if you wish, the only people whose help you actually need to pursue a disability claim are Social Security staff. That is what we are there for. I worked with some fine people serving on the front-line federal public service.

There has been discussion of hearings before an administrative law judge. This happens at the second level of appeal if a claim is denied. Claimants have a choice of whether or not to appear personally at the hearing. We could not officially advise one way or the other, and some claimants were reluctant to appear. I would point out something to consider is that if you do not attend, the administrative law judge sees written reports about you. If you do attend, the administrative law judge sees you as a person and can observe appearances and symptoms just as the claims representative can. The administrative law judge can also question the claimant directly and you can describe how your condition affects you better than any lawyer or written report can.

Jim Jirousek is a retired Social Security field representative.