Disability Benefits

ODAR stands for the Office of Disability Adjudication and Review. It is a branch of the Social Security Administration. Once you have been denied for disability benefits and your appeal is also denied, you file a request for a hearing. At this point your case is forwarded to ODAR.

You will receive various letter from ODAR over the course of your hearing including confirmation that your case was received and notification of when your hearing date is.

The Office of Disability Adjudication and Review holds the hearings and issues the decisions regarding whether or not you will receive disability benefits. There are over 160 hearing offices with more than 1,600 Administrative Law Judges across the nation. It is these ALJs that hear your final appeal and determine whether you will receive benefits of not.

Most social security disability claims are denied the first time they are submitted. About 70% of claimants are denied benefits. That does not mean that you are not eligible to receive disability benefits.

If you are denied, you will get a letter in the mail which will describe your condition, the impairments that were considered, medical records and an explanation of why you were denied. The explanation may be that there are other jobs that you can perform. Or it could state that you missed a deadline or that your substantial gainful activity produced too much income to qualify.

As soon as you have been denied you are able to file a request for reconsideration. This is the first level of appeal. You have 60 days to file this request. (If you miss this deadline you will have to begin your application process all over again.) You will be mailed forms to fill out for the reconsideration which you need to return as soon as possible. The request will be turned over to a disability examiner just like with your first claim.

If your reconsideration appeal is also denied, your next step will be to request a hearing with an administrative law judge (ALJ). This means you will have a face to face meeting where a judge will ask you questions and possibly hear testimony from medical or vocational experts. When the claimant is represented by an attorney the chances of winning benefits with the approval from an ALJ is about 60%.

You may want to consider seeking the assistance of a Social Security Disability Attorney if you have been denied on your initial claim or your reconsideration appeal. These attorneys have been trained in the law and are aware of how to best present your case. You have a better chance of winning your claim with the help of an attorney. If you feel you are eligible for disability benefits then continue to pursue your claim even if it feels daunting.

A consultative exam is a medical examination. Some people who have applied for social security disability benefits are sent for an exam by the Disability Determination Services (DDS) examiner who is handling their claim. Not every claimant will be asked to go for a consultative exam (CE). If your medical records do not have enough documentation or if you have not been seen by your doctor recently, then the DDS examiner will ask you to schedule a CE.

You will receive a letter asking for a consultative exam if one is needed. The consultative exam will not be performed by your own doctor. You will be referred to someone who is an independent doctor and has been contracted by the Social Security Administration. If you are asked to go to a CE it could be because the examiner is simply trying to get more recent medical evidence such as an updated x-ray. It could also mean that your medical records are outdated because you have not seen a doctor in some time. (This is one important reason why you should always continue with your doctor appointments as the doctor suggests so your medical records current, as well as continue any treatment or medication that has been prescribed.) Be sure that you attend the CE if you are asked to go. Failure to attend may give the examiner a reason to dismiss your claim. If you do have a reason for missing a scheduled exam, contact your DDS examiner or the CE physician to reschedule as soon as you know you will not be able to make your appointment.

The examiner will request the information or tests that he needs from the physician. Your exam may include a physical, psychiatric or psychological evaluation and may or may not include blood work, x-rays or an eye exam. The doctor is really looking for information to give the DDS examiner enough information to know what the claimant’s condition is and what their limitations are and will be. This doctor will not be prescribing any medication or treatment. The exam is all about gathering information on the claimant’s condition which will be reported back to the DDS examiner so that your claim can be decided.

Lucille, from Imperial Beach California, asks “I am divorced and never re-married. I have never worked. Can I apply for Social Security Disability benefits under my ex-husband’s work record?”

If you are divorced and never remarried, you might qualify for Social Security Disability Insurance (SSDI) benefits on your ex-spouses record.
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Adrian, from San Bernardino California asks, “Can hiring an attorney really improve my chances at winning my Social Security Disability claim?”

Yes, a disability attorney can help improve your chances at winning a disability or SSI claim at the initial application level, the reconsideration appeal, and especially a disability hearing.
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Tammy, in Oceanside, California, asks “I did not go to college; my highest level of education is High School. Will that make it easier for me to qualify for Social Security Disability?”

When you apply for Social Security Disability Insurance (SSDI) benefits or Supplemental Security Income (SSI) benefits, your symptoms will be compared to an official book that contains all the listings of impairments (also referred to as the “Blue Book”). If your disability is in the listing of impairments and all of your symptoms match the requirements, then you will probably qualify for disability and your education does not affect the decision.
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Terry, in El Cajon, California, asks “Will my spouse’s income affect my Social Security Disability Insurance? “

Your spouse’s income will not affect your Social Security Disability Insurance (SSDI) benefits. Qualifying for SSDI is based only on your work history, your disability and your ability to engage in substantial gainful activity. The income or resources of your spouse will not affect your eligibility for SSDI or the amount you will receive for SSDI benefits. Your savings and investments also will not affect your SSDI eligibility or benefits.
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Substantial Gainful Activity (SGA)
Substantial Gainful Activity (or SGA) is a term used by the Social Security Administration and Disability Determination Services (DDS) to refer to a person’s ability to work and earn enough income that would prevent them from qualifying for disability benefits.
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Travis, in Oceanside California, asks “What qualifies someone as being disabled and eligible for Social Security Disability benefits?”
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Tanya in Del Mar, California asks “If I am found eligible for Social Security Disability benefits in San Diego, how much can I expect to receive each month?”

For Social Security Disability Insurance (SSDI) benefits, the amount you receive will be based on your work history (how many years you have been working) and how much money you earned (and how much money you paid in required Social Security payroll deductions). The more you earned, the more you paid into Social Security, so the larger your disability benefit will be.
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Perry, in Escondido, California, asks “are there some disabilities that are guaranteed to get you approved automatically for SSDI?”

The disability evaluation process is never automatic. Some disabilities are likely to be approved very quickly; however, there is no guarantee that any disability will automatically get approved.
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Trevor, in El Centro, California asks “I had disability claims filed at SSA and VA, my VA claim was approved already, will this help my SSDI claim get approved?”

Many people who are eligible for Veteran’s Administration (VA) disability will file a claim with both the Social Security Administration (SSA) and the VA. It is not unusual to be approved for VA benefits while still waiting on a Social Security Disability Insurance (SSDI) claim or Supplemental Security Income (SSI) claim.
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Greg in Carlsbad, CA, asks “Is it true that the older you are the easier it is to get Social Security Disability?” READ MORE…

Over 70% of initial applications for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits are denied. The sad truth is that most of these denied applications are legitimate claims that will eventually be approved by an administrative law judge. If many of the claims that are denied at the initial application level eventually get approved in a hearing, then why were they denied in the first place?
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Once you are receiving Social Security disability benefits, periodically the Social Security Administration (SSA) will review your case to make sure that you are still disabled. This review is called a Continuing Disability Review (CDR). The SSA performs two types of reviews, a medical continuing disability review and a work continuing disability review. Under a work review, the SSA looks at your earnings to determine if you are eligible for monthly benefits. A medical review is done by a DDS examiner and he/she determines if you are still meeting the medical requirements to collect disability. If you do not meet the medical requirements, SSA may stop the disability benefits.
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