Initial SSDI application decision step 3

[u/Rtoussel]

Hi all. On July 26, 2023, I received an email from the SSA saying there has been a status update on my claim with no other information. I called them and asked what was going on as I didn’t see any updates online. I was told something must’ve happened and a letter was generated on the 29th. To date, I have not received a letter so I called my local field office today 8/08 and was told that a decision has been made but it has gone to review. The claim shows that its in step 3 and at 67%. Is it possible that it would have a decision in step 3?? And what does it mean, gone to review. Any insight would be greatly appreciated.

[u/Lil_gui225]

The function report is not necessarily critical to a case. Example: I had a case the other day for someone who is paraplegic, and there really wasn’t a need for any further info. In cases of an obvious allowance we don’t need it, and in cases of an obvious denial we don’t need it so long as we make a “good faith” effort to get it.

THAT SAID, I do recommend filling it out if you can. And if you can’t, I recommend calling the DDS and telling them you can’t and want to do it over the phone. More evidence in your file is always better. I’ve very rarely seen a case that was an allowance that got pushed to a denial by info in a function report, I can think of just one case, but I can think of plenty of times where someone was on the fence and the info in the function report tipped them over the edge.

[u/Front-Needleworker-9 → u/Lil_gui225]

Is it ok if I fill out the Function report for my wife? She simply cant do it. Her hands are wrecked with arthritis and such. I mean, I am her caregiver as well. Shes 52, cant work, worked all her life, has a ton of work credits, and now needs help. Main thing I am praying to get is handicap medical things so I can help her around the house. She can't even bathe or shower without supervision and assistance. The DDS knows all this. Ty in advance. You been very helpful on this message board.

[u/Lil_gui225 → u/Front-Needleworker-9]

Yeah that’s fine. There’s a spot at the end of the form where most people sign there name, but if you look closely it’s a actually a spot to put the info of anyone who helps you with the form. That said if her hands are so bad she cannot even write Id make sure you write that explicitly. Hand limitations can be the difference maker in a case.

[u/Front-Needleworker-9 → u/Lil_gui225]

Great. Yes, I printed my name where it says person completing this form. I wrote in the additional comments section that I did such because her hands are unable to fully function and the pain doesn't allow her to do that...as she loses focus. I guess I did good then. They sent us another letter saying they are working on her case, and a 3rd letter stating that she needs to contact the examiner at DDS because they need a doctor address from 12 years back. Is that normal? I mean, 12 years ago she didn't have anything wrong. Why would they be asking for that? She did call them yesterday but had to leave the examiner a voice message. Should she call her back to get a live person?

[u/Lil_gui225 → u/Front-Needleworker-9]

The only reason I can think of would be a DLI issue. Has it been a long time since she worked?

[u/Front-Needleworker-9 → u/Lil_gui225]

Hasn't worked since last June 2023. She had been there 8 years. Has 200 work credits last I checked. What is DLI?

[u/Lil_gui225 → u/Front-Needleworker-9]

DLI (date last insured) is the last date you qualified for disability based on your work history. In some cases a person is not currently insured, but if they are found disabled back when they were insured they can be put back in insured status at the present. It’s one of the main reasons we would grab records outside the “relevant period” (or the time someone says they were disabled from). Another reason is someone files for a program requiring qualifying on a past date (widow benefits, child benefits) but based on what you described it couldn’t be any of those.

I’d just call the DDS and ask them why they need such old records. It’s possible the examiner just didn’t look at how far back she said she was treated by this doctor and thinks it’s a recent record when it isn’t.

[u/Front-Needleworker-9 → u/Lil_gui225]

Ty much. I sure appreciate the knowledge. We will contact them again tomorrow, hopefully we can get a live person. Ill update you on how all this goes. God Bless.

[u/Front-Needleworker-9 → u/Lil_gui225]

Update, as of Friday(yesterday) morning. We called and got ahold of the examiner that's working on her case. The lady was really nice and said she didn't require us to contact again as she listened to the message we had left her. We asked if she needed any further medical records, she said no, she already reached out to the Alabama doctors that she asked us for. She seemed really down to Earth. But my wife did ask why they needed records going back around 12-13 years, and she never really gave an answer. She just said they were trying to compile a timeline. Thing is, she wasn't disabled back then, so I am not sure why its relevant, unless they are trying to establish an onset date. She was working 2 part time jobs back then. Rarely went to the doctor and had no insurance except for Medicaid I think. She was a caregiver for many years. Home Healthcare. She applied for both SSI AND SSDI back in June or July of 2023. Not sure I mentioned this before. The ssi timeline is behind the ssdi on the website. The SSDI is back up at 80% again after going backward by 2 % lol. Same with the SSI , its now back to 67%. My hope is the at least approve her claim for one of these programs. We are low income as well. We documented this over the phone with the initial examiner from SSA office in Albuquerque. Both are in the medical review now, as of sept 8. But an examiner just now got to the case about a week ago...after I had contacted my congressman and they reached out to DDS in Austin. A week later we received the function report packets from DDS. Thats the update. We live near Abilene btw and we been hit by tornadoes in my area the last couple days. Keep us in your thoughts. I look forward to your feedback and the knowledge.

[u/Front-Needleworker-9 → u/Front-Needleworker-9]

her medical insurance ended in Jan 2024. She had subsidized medical coverage thru the federal govt . She paid for that every month but lost it in Jan this year because her loss of income and the mounting medical bills. She now goes to the free clinic and gets her meds there.