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OHIO’S INJURY & SOCIAL SECURITY DISABILITY FIRM Workers' Compensation - Social Security Disability - Personal Injury

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21 Things that Can Give your Disability Claim “Priority Processing” Status

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We’re gonna be straight with you: Social Security has a really hard time making decisions. Well, it’s not so much the decision itself; it’s the volume of appeals that are part of the due process of filing a Social Security disability claim.

Social Security hearing wait times continue to rise despite many initiatives that Social Security has started to shorten them. It is no different at the Appeals Council level of the process.  It, too, has a huge backlog.

A Request for Reconsideration of a Hearing Decision is the appeal that takes a denial at hearing to a higher level: the Appeals Council. Generally, this level is asked to review the hearing itself—the testimony of the claimant, representative, vocational or medical expert and the Administrative Law Judge—to see if anything was done that was contrary to the correct hearing process.

Priority Processing

Recently, the Appeals Council instituted Priority Processing in hopes of reducing the backlog. Here’s a summary of that process, from a recent NOSSCR newsletter:            

A list of the Appeals Council-level cases with newly submitted evidence is generated several times a week. A group of employees has started screening the listed cases to see if they meet any of the 21 circumstances below. If so, the branch chief receives the case and assigns it for priority processing. The circumstances are:

(1) Age 55
(2) Any indication or report of death
(3) Hospice, nursing care, or claimant cannot care for personal needs
(4) Intensive care unit for more than 3 days
(5) Hospitalization for more than 7 days
(6) Transplant notes (kidney, heart, heart/lung, liver or bone marrow, etc.)
(7) Transplant waiting list
(8) Cancer with poor or no response to treatment
(9) Cancer that has spread to other areas/
(10) Coma
(11) Heart attack or myocardial infarction
(12) Stroke, or cerebral vascular accident
(13) Prescribed use of home oxygen 
(14) Prescribed use of wheelchair
(15) VA disability rating of 70% or more
(16) Letter or notice approving other forms of disability payments
(17) Medical report(s) of a terminal prognosis
(18) Dialysis or End Stage Renal Disease (ESRD)
(19) Blood transfusion(s)
(20) Bed or home confinement
(21) Very rare, unusual, or compassionate allowance diagnoses

If you are currently waiting for an Appeals Council decision on your appeal and any of these 21 circumstances apply to you since your hearing, contact Social Security immediately with the appropriate documentation—or if you are represented by a law firm, contact them. If you are seeking representation, give us a call!

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