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Claimant’s Responsibilities

by | Dec 27, 2016 | SSD - Social Security Disability Process And Benefits |

Anyone who has paid enough taxes under the Federal Insurance Contributions Act (FICA) has a right to file a claim for Social Security Disability benefits under Title II of the Social Security Act. Even without coverage under Title II, an individual who is disabled may also file a claim for Supplemental Security Income benefits under Title XVI, provided they meet the poverty guidelines. Yet, the right to benefits comes with responsibilities. The duty of filing the initial application, for example, is on the claimant. Many claimants do not file their claim on time, potentially costing them a loss of back pay.

While the Social Security Administration (SSA) will do much to assist the claimant in processing their claim, an attorney or other representative may also help guide the applicant through the process. Even with a representative, however, the claimant still retains some responsibilities. For instance, a claimant should keep always keep their representative and/or Social Security Administration apprised of any changes in their contact information. Federal offices may be ill-equipped to track down claimants who change residences without proper notification. Likewise, if a claimant has not had contact with their representative in a reasonable period of time, there is a good chance the representative might not have current phone numbers.

Also, the burden of proving disability is on the claimant for steps one through four of the sequential evaluation process. This includes the burden of establishing the existence of a severe medical impairment with treatment records. While SSA and/or a representative will do their best to obtain your records, the claimant and representative have an affirmative duty to disclose the existence of such treatment documents, whether favorable or unfavorable.

For those applicants who have been unable to see a doctor due to lack of insurance, the Affordable Care Act currently provides aid in obtaining insurance, where many disabled individuals would otherwise be unable to prove their claim. SSA may also refer the claimant to a consultative medical evaluation. It is important to note that a consultative evaluation is not treatment. While a consultative evaluation may provide a clearer view into your medical condition for the purposes of a disability claim, the examiner cannot provide actual medical treatment and has no duty to follow up with the claimant. As with the right to file for public benefits, the primary responsibility remains with the individual claimant.

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