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A Social Security Disability Claim Denied By Fault Of The SSA - Are Any Of Them Held Accountable For Their Mistakes?

Houston, TX |

Consider the scenario of a social security disability claim that ends up taking many, many years to get approved. The claim suffers from many mistakes throughout each stage of the 5 step process and involves the local SSA, DDS, ODAR, the AC, and an ALJ - each has contributed to the delay of benefits.

For this scenario, the claimant has written to each department trying to point out the many errors of record yet nothing was ever corrected. If in the end the claimant can show the claim should have been approved at the initial stage (before any hearing), is there ever any reprimand to those involved that contributed to the constant errors? If not, what is to keep them from making the same mistakes again? What happens when a claimant suffers from a total collapse of due process?

Attorney Answers 4

  1. Best answer

    If there were consequences upon reversal of a claim in terms of reprimands to decision makers early in the social security disability appeal process there would indeed be blood running in the halls of the state DDSs. Arguably the same claim at initial may not be the same claim at reconsideration in the sense that later important medical evidence may have become available at recon. While I would agree with the notion that accountability is a problem in any institution, particularly government, I would see great potential for unfairness in punishing earlier deniers when a later decision-maker says yes.

  2. The short answer is there is no "reprimand" to anyone at SSA for their decisions, and nothing prevents them from making the same mistakes or same kind of decisions. That is how the system is set up and, unfortunately, the client suffers. There is no remedy for the client - except perhaps an EAJA fee for the attorney if the case has o go to Court and the government's positions was so egregious that the court agrees SSA was not "substantially justified" in making the decision it made, which could reduce the fees the client has to pay the attorney.

    Best of luck to you!

    The exact answers to questions like this require more information than presented. The answer(s) provided should be considered general information. The information provided by this is general advice, and is not legal advice. Viewing this information is not intended to create, and does not constitute, an attorney-client relationship. It is intended to educate the reader and a more definite answer should be based on a consultation with a lawyer. You should not take any action that might affect your claim without first seeking the professional opinion of an attorney. You should consult an attorney who can can ask all the appropriate questions and give legal advice based on the exact facts of your situation. The general information provided here does not create an attorney-client relationship.

  3. Each level of review accords you the right to appeal the decision and to cite the errors. The term "error" falls into two categories: legal and factual. You are the expert in the facts of your case, but unless you are an attorney practicing SS law, it is highly unlikely that you have the legal knowledge to spot and understand all of the legal errors, and whether those errors may be "harmless" errors. You sound very frustrated and appear to have been through many levels of review, although I do not see federal court listed in your question. You also do not state whether your claim was ultimately approved. I strongly suggest, that if you have not yet been approved, seek the advice of an experienced Social Security attorney regarding the next level of appeal, or the advantage/disadvantage of filing a new claim. If you were finally approved, then it is indeed unfortunate that the process was so frustrating for you. There are no reprimands to those who reviewed your case at any level - it comes down to each reviewer's "interpretation of the evidence" which is why you have the right to appeal. Good luck to you.

  4. The fact that a claim was eventually approved does not by itself mean that there was fault upon the agency. There are many complex rules and regulations that Social Security must follow in evaluating a claim. Even in cases were we use the same information to get a case approved that was submited with the initial claim does not mean that the agency intentionally denied this claim.

    Your only rights, unfortunately, are to file your administrative appeals. In some cases, we have had cases expedited when we were able to show an obvious adminstrative error, like Social Security using the wrong date of birth.

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