Denied SSDI because i'm on AD still.

bcbberry

PEB Forum Veteran
Registered Member
#42
That's great news! I was coming to let you know that I too went through the same round and round. I was denied initially at the admin stage due to still being paid while AD. They stated I made too much. I was told by the WW coordinator afterward that I should have marked my pay as "compassion pay". Then for my reconsideration I got a lawyer.

She got me the form you talked about and my command filled it out. The local office then lost my file. Lost it. It was a paper file. The whole reconsideration packet. That got fixed after months but Denied again due to finances. So my lawyer had a long talk and onto the next reconsideration.

Finally it went to medical. This time I was denied at the medical level. So ALJ hearing we went. I was discharged and moved back home. 8 months later I had my hearing Jan 2nd 2018. Feb 1st he made a decision and I was found fully favorable backdating to 2014. So don't give up!!! It can be a long process. Hopefully you hear good news soon!
 

Orange Sky

PEB Forum Veteran
Registered Member
#44
Please send to me as well? I have been fighting with my local SSA office since last year over SSDI. I am still AD and denied the first time because I made too much. I appealed for reconsideration. I was denied that time because I was performing substantial gainful activity (I show up to work at sit behind me desk, miss a lot of work, etc) but based on me being on AD and making too much, I can't get past the initial qualification. Thank you.
 

Sgt zo

PEB Forum Veteran
Registered Member
#45
It's good to know that SSA got your case fixed bcbberry. I'd like to know what can be done so that SSA is more aware of the rules regarding military pay and SGA. Seen very unfair that you have to fight just to get that point across.
 

Sgt zo

PEB Forum Veteran
Registered Member
#46
Please send to me as well? I have been fighting with my local SSA office since last year over SSDI. I am still AD and denied the first time because I made too much. I appealed for reconsideration. I was denied that time because I was performing substantial gainful activity (I show up to work at sit behind me desk, miss a lot of work, etc) but based on me being on AD and making too much, I can't get past the initial qualification. Thank you.
Is active duty the only income that you Have? I just noticed that you were denied on appeal. Somebody at that level should known the rules.
 

GSWarrior2017

PEB Forum Veteran
Registered Member
#47
Got a phone call yesterday that I will need to go to a scheduled exam before my case is decided. Anyone else have experience to share on the SSA ordered exam?
 

Warrior644

Staff Member
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#48
Got a phone call yesterday that I will need to go to a scheduled exam before my case is decided. Anyone else have experience to share on the SSA ordered exam?
Indeed and a good deal for sure...

Upon my submission of a SSA SSDI application as a Wounded Warrior while still on military active duty in the 2012 calendar year, I received a letter from the SSA DDS stating that I was scheduled for a SSA consult medical examination. The purpose of the SSA paid medical consultation was to receive additional medical information since my SSA SSDI case file did not have ample supporting medical evidence for a particular medical condition in which I was claiming. The SSA DDS wanted to ensure that they yielded a comprehensively "fair and expeditious" recommendation as a Wounded Warrior applicant for SSDI compensation benefits in direct support of the HQ SSA's approval or disapproval final decision.

As such, fortunately for me, the SSA paid consult overwhelmingly supported my SSDI claimed medical condition's symptomology. Eventually soon afterwards, I was awarded SSA SSDI federal disability compensation benefits within 76 calendar days after my initial SSDI application submission while still on military active duty. Bottom line, it's a SSA regulatory procedure/process for the SSA DDS in their medical review of all SSA SSDI case files to issue a "disabled" determination.

So, the receipt of a SSA ordered exam should not be initially viewed as a negative mandatory event. Albeit, not attending the SSA medical consultation could potentially result in a SSA DDS unfavorable recommendation to receive a "disabled" determination for the receipt of SSDI compensation benefits at least in my experienced opinion. Take care!

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer!"

Best Wishes!
 

bleacherspy

PEB Forum Veteran
Registered Member
#49
Same experience as Warrior... My SSA exam seemed like more of a check in the block just to make sure my condition was validated by an SSA doc.
 

GSWarrior2017

PEB Forum Veteran
Registered Member
#50
Same experience as Warrior... My SSA exam seemed like more of a check in the block just to make sure my condition was validated by an SSA doc.
Indeed and a good deal for sure...

Upon my submission of a SSA SSDI application as a Wounded Warrior while still on military active duty in the 2012 calendar year, I received a letter from the SSA DDS stating that I was scheduled for a SSA consult medical examination. The purpose of the SSA paid medical consultation was to receive additional medical information since my SSA SSDI case file did not have ample supporting medical evidence for a particular medical condition in which I was claiming. The SSA DDS wanted to ensure that they yielded a comprehensively "fair and expeditious" recommendation as a Wounded Warrior applicant for SSDI compensation benefits in direct support of the HQ SSA's approval or disapproval final decision.

As such, fortunately for me, the SSA paid consult overwhelmingly supported my SSDI claimed medical condition's symptomology. Eventually soon afterwards, I was awarded SSA SSDI federal disability compensation benefits within 76 calendar days after my initial SSDI application submission while still on military active duty. Bottom line, it's a SSA regulatory procedure/process for the SSA DDS in their medical review of all SSA SSDI case files to issue a "disabled" determination.

So, the receipt of a SSA ordered exam should not be initially viewed as a negative mandatory event. Albeit, not attending the SSA medical consultation could potentially result in a SSA DDS unfavorable recommendation to receive a "disabled" determination for the receipt of SSDI compensation benefits at least in my experienced opinion. Take care!

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer!"

Best Wishes!
Thanks, guys! I really appreciate your experience and your willingness to share!
 

GSWarrior2017

PEB Forum Veteran
Registered Member
#52
Finished my Social Security Comprehensive Exam (CE). The doctor was very kind and understanding. Now I wonder how long it will take before the SSA/office makes a decision on my case.
 

GSWarrior2017

PEB Forum Veteran
Registered Member
#53
Indeed and a good deal for sure...

Upon my submission of a SSA SSDI application as a Wounded Warrior while still on military active duty in the 2012 calendar year, I received a letter from the SSA DDS stating that I was scheduled for a SSA consult medical examination. The purpose of the SSA paid medical consultation was to receive additional medical information since my SSA SSDI case file did not have ample supporting medical evidence for a particular medical condition in which I was claiming. The SSA DDS wanted to ensure that they yielded a comprehensively "fair and expeditious" recommendation as a Wounded Warrior applicant for SSDI compensation benefits in direct support of the HQ SSA's approval or disapproval final decision.

As such, fortunately for me, the SSA paid consult overwhelmingly supported my SSDI claimed medical condition's symptomology. Eventually soon afterwards, I was awarded SSA SSDI federal disability compensation benefits within 76 calendar days after my initial SSDI application submission while still on military active duty. Bottom line, it's a SSA regulatory procedure/process for the SSA DDS in their medical review of all SSA SSDI case files to issue a "disabled" determination.

So, the receipt of a SSA ordered exam should not be initially viewed as a negative mandatory event. Albeit, not attending the SSA medical consultation could potentially result in a SSA DDS unfavorable recommendation to receive a "disabled" determination for the receipt of SSDI compensation benefits at least in my experienced opinion. Take care!

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer!"

Best Wishes!
So, I have been waiting on the SSA's decision since my previous CE, but I just got another phone call today from the SS Office saying that I will now have to go to a Mental CE next month. Is this normal? I made no claims for anything mental. My case is overwhelmingly physical and easily observable with plenty of physical medical evidence. Not sure why I'd need to go to a medical exam.

This back-and-forth has been going on since OCT 2017 when i first applied as an AD Wounded Warrior. I was told I'd be expeditiously processed due to my Wounded Warrior status. Is this supposed to be their version of expeditious?
 

Warrior644

Staff Member
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PEB Forum Veteran
Registered Member
#54
So, I have been waiting on the SSA's decision since my previous CE, but I just got another phone call today from the SS Office saying that I will now have to go to a Mental CE next month. Is this normal? I made no claims for anything mental. My case is overwhelmingly physical and easily observable with plenty of physical medical evidence. Not sure why I'd need to go to a medical exam.

This back-and-forth has been going on since OCT 2017 when i first applied as an AD Wounded Warrior. I was told I'd be expeditiously processed due to my Wounded Warrior status. Is this supposed to be their version of expeditious?
In retrospect, a consultative examination (CE) is any additional exam or test called for when an applicant's current medical information is considered insufficient by the SSA DDS in rendering a decisive Social Security Disability determination. Depending on how much information the DDS claims examiner needs, the appointment may include a physical, and/or a psychological or psychiatric exam (as well as diagnostic tests, like x-rays and blood work). Is this normal? Yes, in my experienced opinion. Is this expeditious? Yes, since normal DDS processing alone historically averages about 12 months in total time.

Within the Online Social Security Handbook, Chapter 6 - Factors in Evaluating Disability's "Evidence of Disability" it states ...

616. Consultative Examinations

616.1 When do you need a consultative examination?
We may require a consultative examination in situations including, but not limited to, the following:
  1. To gather more evidence because the evidence obtained is not enough to make a disability determination;
  2. To obtain more detailed medical findings about your impairment(s);
  3. To obtain technical or specialized medical information;
  4. To resolve conflicts or differences in medical findings in the evidence already in file; or
  5. To resolve the issue of your ability to do substantial gainful activity, if you are an adult; or, if you are a child under age 18, your ability to function like other children your age who do not have impairments.
We pay for necessary consultative examinations.

616.2 Who administers the consultative examination?
Your medical source will be the preferred source to perform the consultative examination. However, we may use a different medical source other than your medical source in certain situations. In some situations, we pay travel expenses relating to a medical examination required in connection with a disability determination.

616.3 What happens if you refuse a consultative examination?
If you refuse a consultative examination without good cause, we make a decision based only on the evidence in your file.

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer!"

Best Wishes!
 

Sgt zo

PEB Forum Veteran
Registered Member
#55
Yes, your file review was expeditious, there are people that wait 6 months just to get a response. Getting your claim processed and finalized can take some time. You are making progress, just give timely responses to whatever they ask for.
 

GSWarrior2017

PEB Forum Veteran
Registered Member
#56
In retrospect, a consultative examination (CE) is any additional exam or test called for when an applicant's current medical information is considered insufficient by the SSA DDS in rendering a decisive Social Security Disability determination. Depending on how much information the DDS claims examiner needs, the appointment may include a physical, and/or a psychological or psychiatric exam (as well as diagnostic tests, like x-rays and blood work). Is this normal? Yes, in my experienced opinion. Is this expeditious? Yes, since normal DDS processing alone historically averages about 12 months in total time.

Within the Online Social Security Handbook, Chapter 6 - Factors in Evaluating Disability's "Evidence of Disability" it states ...

616. Consultative Examinations

616.1 When do you need a consultative examination?
We may require a consultative examination in situations including, but not limited to, the following:
  1. To gather more evidence because the evidence obtained is not enough to make a disability determination;
  2. To obtain more detailed medical findings about your impairment(s);
  3. To obtain technical or specialized medical information;
  4. To resolve conflicts or differences in medical findings in the evidence already in file; or
  5. To resolve the issue of your ability to do substantial gainful activity, if you are an adult; or, if you are a child under age 18, your ability to function like other children your age who do not have impairments.
We pay for necessary consultative examinations.

616.2 Who administers the consultative examination?
Your medical source will be the preferred source to perform the consultative examination. However, we may use a different medical source other than your medical source in certain situations. In some situations, we pay travel expenses relating to a medical examination required in connection with a disability determination.

616.3 What happens if you refuse a consultative examination?
If you refuse a consultative examination without good cause, we make a decision based only on the evidence in your file.

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer!"

Best Wishes!

Thank you for all of the information. The SS Handbook paints with very broad strokes and does not delve into the specifics of what ailments constitute which types of CEs--only that CEs can be needed and scheduled for 5 categories of reasoning. I suppose my question is too specific to my situation to be easily answered by the guidelines set forth in their generalized guidance. I have a paralyzing spinal condition, and claimed no mental conditions, and I must now go to a mental evaluation of some sort. I was just trying to see what the logic was in that mode of examination. Are they looking for psychological factors to indicate symptom magnification? Are they looking to add conditions such as depression due to chronic pain to my case that I did not claim? I'm sure the motives could be be a wide range of things, but I digress...I will go and do whatever I am asked.

On a side note, you mentioned that expeditious is anything within a 12 month average? I am going to assume that this is different from state to state, and city to city. When I spoke to the Social Security Administration/Office in my state, the agent stated that it is their agency's policy to expedite Wounded Warriors to not exceed 4 months in full processing time--from application to final decision. They admitted that my case is taking much longer than it should given the evidence they already have. The agent I talked to on the phone could not correlate the mental exam to anything in my case file (she seemed confused by it), and she ended up noting that someone went into the "system" and changed my application date from 13 OCT 2017 to 31 JAN 2018--thus providing more processing time to meet the Wounded Warrior goal. I'm not okay with that, and I've taken appropriate action to address it.

Thanks for taking the time to read my situation, and thank you for providing your insight! Always appreciated!
 

Warrior644

Staff Member
PEB Forum Lifetime Supporter
PEB Forum Veteran
Registered Member
#57
Thank you for all of the information. The SS Handbook paints with very broad strokes and does not delve into the specifics of what ailments constitute which types of CEs--only that CEs can be needed and scheduled for 5 categories of reasoning. I suppose my question is too specific to my situation to be easily answered by the guidelines set forth in their generalized guidance. I have a paralyzing spinal condition, and claimed no mental conditions, and I must now go to a mental evaluation of some sort. I was just trying to see what the logic was in that mode of examination. Are they looking for psychological factors to indicate symptom magnification? Are they looking to add conditions such as depression due to chronic pain to my case that I did not claim? I'm sure the motives could be be a wide range of things, but I digress...I will go and do whatever I am asked.

On a side note, you mentioned that expeditious is anything within a 12 month average? I am going to assume that this is different from state to state, and city to city. When I spoke to the Social Security Administration/Office in my state, the agent stated that it is their agency's policy to expedite Wounded Warriors to not exceed 4 months in full processing time--from application to final decision. They admitted that my case is taking much longer than it should given the evidence they already have. The agent I talked to on the phone could not correlate the mental exam to anything in my case file (she seemed confused by it), and she ended up noting that someone went into the "system" and changed my application date from 13 OCT 2017 to 31 JAN 2018--thus providing more processing time to meet the Wounded Warrior goal. I'm not okay with that, and I've taken appropriate action to address it.

Thanks for taking the time to read my situation, and thank you for providing your insight! Always appreciated!
Indeed, no worries; you are quite welcome. You have a positive demeanor and that shall assist you greatly throughout the SSDI application processing at least in my opinion.

My research indicated that the SSA DDS by itself was averaging around 12 months for completion under the normal processing of applications; not Wounded Warrior or any other expedited cases. It's great that your state has implemented a significantly less processing procedure for Wounded Warriors, and they are trying their best to meet that goal. Hopefully, you shall receive a favorable DDS determination soon resulting in a SSA "disabled" finding for approved SSDI compensation. Take care!

Thus, I quite often comment that "possessing well-informed knowledge is truly a powerful equalizer!"

Best Wishes!
 

Pyro

PEB Forum Veteran
Registered Member
#59
My wounded warrior approval for SSDI took 3 weeks. Show up to the SS office in uniform with all the medical paperwork you have, fill out everything in person. I don’t remember taking anything home, just a phone call 3 weeks later saying I was approved and a large check about 1 week after that. If you need more prep than that, Your case might be a bit shaky.
 

brianmatt31

PEB Forum Veteran
Registered Member
#60
I’m gonna send you the SSDI program instructions called POMS and DI’s that specifically talk about Wounded Warriors and military pay with respect to SGA. Take them with you and show them what their own instructions say.

Hi Bleacherspy. Can you send me a copy also. I got denied within two months and tried to appeal the next week and the website wouldn't allow it. lol so I'm starting over. Email is [email protected]
 
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