DAVID S. KAPLAN
David S. Kaplan, Esq., grew up in Collegeville and is a graduate of Perkiomen School, Ursinus College and The University of Pittsburgh School of Law. He has been a member of OWM since 1983 and resides in Chester County with his wife, Diana.
Mr. Kaplan is active in the Collegeville Rotary as Past President and, most recently, Assistant Governor. He has been a leader in many community organizations and Montgomery Bar Assn. Committees and is a member of the National Organization of Social Security Claimants’ Representatives (NOSSCR). He authored the Estate Mate Planner with the The Executor's Job: A Guide for your Executor, now incorporated into the OWMLAW website.
Mr. Kaplan's areas of concentration are Estate Planning/Administration and Social Security Disability. He is also an active mediator.
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The material in this publication was created as of the date set forth above and is based on laws, court decisions, administrative rulings and congressional materials that existed at that time, and should not be construed as legal advice or legal opinions on specific facts. The information in this publication is not intended to create, and the transmission and receipt of it does not constitute, a lawyer-client relationship.
The Social Security Disability Application Process
A person with a severe medical condition who is prevented from any substantial gainful employment applies for disability at a Social Security Administration (“SSA”) field office. Field offices in the area near OWM Law’s Pottstown and Phoenixville offices are the Limerick office (Royersford mailing address), Reading, Norristown, West Chester and Allentown. These are part of a network of 61 field offices spread about in the Commonwealth of Pennsylvania. A person, whether claiming the benefits they have earned for Social Security Disability Insurance (“SSDI”) or qualifying for Supplemental Security Income (“SSI”), applies for benefits through the field offices.
The applications can be filed by a person physically going into the field office or can be filed on line. Individuals filing on their own are approved at a rate of approximately 32%. This rate varies from state to state and has improved slightly in Pennsylvania over the past year. Individuals who are counseled in the process with the help of an attorney have a significantly better chance of receiving benefits with the initial application.
When applying, the claimant wants to set forth his or her best case as quickly as possible. Although a denial can be appealed to an Administrative Law Judge, most claimants wait a year and a half or more before they get their hearing. Therefore, the proper organization of medical information and setting forth the correct details in an application, are extremely important for each claimant.
When a person applies, they are submitting detailed information about their medical and job history to the SSA field office. That field office processes the submitted information to make sure all required questions are answered, and helps determine whether a person should be filing for SSDI or SSI. Once that basic information has been received by the field office, it is forwarded to the Pennsylvania Bureau of Disability Determination (“BDD”) to review all of the medical information, and to make a medical determination as to whether a person is disabled.
The BDD is a branch of the Pennsylvania Department of Labor and Industry. There are three regional offices in the state, Wilkes-Barre, Harrisburg and Greensburg. Most claimants in Southeast Pennsylvania will have their claims reviewed in the Wilkes-Barre office.
When the SSA field office forwards the claim to the BDD for evaluation, an examiner/adjudicator requests all medical records from the doctors, hospitals, clinics and other types of medical providers that the applicant has listed. The examiner also sends out several forms to the claimant requesting details about their activities of daily living and their work history. All of that information is then forwarded to a medical professional who reviews the records and makes a recommendation to the adjudicator regarding the claimant’s medical limitations. The adjudicator applies the medical limitation to the criteria established by Social Security law to make an overall determination as to whether the claimant should receive benefits.
The process of evaluating a claim through the various levels of review takes months. The length of time will vary depending how rapidly the medical providers return information to the examiner, or what special issues the adjudicator may find in a particular case. I generally advise my clients that they should not expect a response on their application for at least four months. The BDD would like to move the applications as rapidly as possible, yet it is more important to get it right. Currently, close to 150,000 new disability claims are received by the BDD each year. Additionally, they are requested to review about 25,000 cases of people who are currently on disability and whose medical condition may now be changed. Each of those claims is separately evaluated by one of the 329 adjudicators spread through the three Pennsylvania BDD offices.
OWM Law will be happy to meet with potential disability claimants, help them evaluate the strength of their case, and guide them through the detailed filing process to maximize the chances of recovering benefits.
If you would care to discuss the above in detail, please call me at 610-323-2800 or email me at firstname.lastname@example.org. Also, please watch OWM's November 2016 Legal Talk program regarding the Social Security Disability Application Process featuring our guest, Steven Rollins, Director of the PA Bureau of Disability Determination, on our website here.
Watch Legal Talk, brought to you by OWM, on PCTV, Tuesdays at 8:30 on Channel 28, and Thursdays at 9:30 p.m. on Channel 98, or on our website here.
Read Legal Ease every first and third Sunday in the Pottstown Mercury.