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SSDI Wounded Warrior "Expedited" Claim...looking for feedback sitting at one year in initial processing

sinasasin

PEB Forum Regular Member
Registered Member
Context:
-2016-2020: underwent two consecutive MEBs
- Determined 100% P&T Disabled by Service Branch and the VA, also designated as housebound
- 47 collective rating, both Mental Health and Physical
-- Even if you were to remove the 100% PTSD rating, I would still have received 100% P&T on physical disabilities
- While still on Active Duty I applied with the Federal Benefits Unit in Frankfurt for SSDI
--Supplied everything that was asked for
-The Social Security website states they received my package Feb 10 2020.

My and my Wounded Warrior rep was informed that I would receive expedited processing. We were told that the standard for anyone else was 30-90 to receive the initial assessment. So in theory a Wounded Warrior might expect half that time.

Also we took note that since 2017 that the SSDI does not need to be in lock-step with the VA concerning ratings. However that it has been challenged and multiple courts have determined assessors should give serious weight to the VA evidence and determination. Okay, that seems fair is suppose, mind you my 5000+ medical records and almost 23 years of Service and tow separate Government agencies already acknowledging I'm jack-u to the tune of 47 rated disabilities that are considered static/life long .

- February passed, and I reasonably consider there my be a slight delay to to COVID
- Even the average US citizen should have heard something by May 1st
- I keep my Wounded Warrior Rep and Federal benefits unit in the loop
- July they ask if I was a WTU, I replied I've been in a modified WTU and have not functionally or operationally worked sine 2016. I then provide performance reports that reflect I was not working and not rated in accordance with regulation XXXblahblah. They asked if I could provide Work Status Questionnaire to be completed by my Supervisor. He happened to be CMSgt in charge at the European/African Headquarters level as the functional career field manager, Thus exceptionally qualified to provide input. He states I've been non-op/not functional since 2016, and identified the severity of my disabilities and there day to day work impact. I felt this reflected well in favor of SSDI approval.
- August Rolls around, I retire, I forward to them my DD-214 which identifies I've been medically retired and the reason for separation is Combat related Disabilities
- I Also received VA ratings in August, which officially stamp this as the final and official outcome.

I forward this to my Wounded Warrior Rep and my Federal Benefits claim Rep asking that they be included in my package, Was told the would be and are.

It has now been at least 180 days, well past even the standard timeframe much less an "Expedited Wounded Warrior"

September-December there was nothing, though i checked the online status on the Social Security page...still reflected initial processing.
- I Contact the Federal benefits unit who stated that this was being handled by the SSA in the state of Massachusetts, allegedly they handle all overseas request. He said to contact them in Jan 2021.

_ I have my Wounded Warrior Advocate reach out, he provides a name and say i am welcome to contact her.
- I oblige and introduce myself and offer to help her help as i am able.
- She asked if i continue to receive Mental health, i state of course but that is seen in the completed package,
- They are now saying that I may need to gather all these other records as well as potentially see an appointed mental health examiner,
- mind you this is 2 weeks shy of a year at this point and nothing feels at all expeditious, nor does it appear that the are applying serious weight to the evidence before them.

I'm very frustrated and upset, I feel I've been treated poorly and that there is no way that taking a year to get an initial determination is the standard. When i asked the SSA point of contact she informed me that the FBU would be contacting me by mail to gather these additional documents and prepare for another mental health exam. Which I understand that there are some different standards between the agencies...but trust when i say i got the full party package when it comes PTSD.

Anyway let s assume that this take another 6 months, then God willing i still would not see a payment until 5 month from the approval date, So that is two years assuming initial package approval and no appeals.

Am I wrong in believing that the "Wounded Warrior 100% P&T with housebound" Expedition review was not applied and if anything they may be reaching for things to cover up that fact that there was no progress for a year.

Would this fall into the real of a Congressional? I've never had to pull the triggers on one, but this seem like the sort of thing they might sanity check.

Any feedback/shared experience would be greatly appreciated as i have almost no one to sound board these types of this off of.

Thanks
 

oddpedestrian

Super Moderator
Staff Member
PEB Forum Veteran
Lifetime Supporter
Registered Member
Takes forever I am hearing they are way behind for 2020 like record breaking behind with that said you will not have the waiting period its from when you applied which is typically your approval date as well so you would get back pay. Here is an excellent article that addresses all your points and what needs to be done to fix it.

 

sinasasin

PEB Forum Regular Member
Registered Member
Takes forever I am hearing they are way behind for 2020 like record breaking behind with that said you will not have the waiting period its from when you applied which is typically your approval date as well so you would get back pay. Here is an excellent article that addresses all your points and what needs to be done to fix it.

Thank you for the prompt input and very informative link.

Elsewhere, another helpful vet shared the link to a Social Security Administration Office of Inspector General Audit Report on the topic:

Their own finding identify severe deficiencies, notably:

“We could not determine whether SSA processed MC/WW and VAPT claims expeditiously because SSA policy did not define expeditious. SSA procedures directed claims adjudicators to “Give MC/WW cases priority processing using the expedited terminal illness (TERI) instructions through all levels of case development and adjudication. ”While the TERI case instructions contain such precise language as “. . . expedite assignment of the case for review no later than the next business day.” Other parts of the instructions are less specific, such as “. . . the assigned [disability examiner]: Develops and adjudicates as a priority.” Without a clear definition of expeditious, SSA does not know whether it is meeting this standard.”

I would be grateful for any additional insight or source of information, and will equally post anything that i find or was shared to me.
 

chaplaincharlie

Super Moderator
Staff Member
PEB Forum Veteran
Lifetime Supporter
Registered Member
The five months began the day you applied. If your claim is approved, you should receive back pay. Have you contacted your Congressman?
 

sinasasin

PEB Forum Regular Member
Registered Member
The five months began the day you applied. If your claim is approved, you should receive back pay. Have you contacted your Congressman?
Charlie,

Thank you for pointing that out, I originally misunderstood this timeframe.

I've not yet contacted my Congressman. I was trying to get a feel of others opinion on doing so. I wasn't sure if I was wrong in my belief that we are well past reasonable.

While I am familiar with others utilizing thier Congressman for MEB/PEB related issues via the forum, I've not heard of seeking help for this type of scenario. I did a basic Google search and it seems that it is been requested by others.
 

Ghnkit

Well-Known Member
PEB Forum Veteran
Registered Member
I applied under the same program for SSDI in April of of 2020 and was approved by September 2020. I am very sorry to hear your situation. It seems someone dropped the ball I would definitely contact your congressman.
 
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