What does processing the medical portion of your claim mean

“A Medical Decision Has Been Made”

Has the Social Security website been sending you cryptic love notes? Wondering what in the world they are talking about? Below you will find an explanation for:

• Benefit Application Under Review
• Appeal Under Review

What They Say

For new applications: “Benefit Application Under Review: A medical decision has been made and we are working to process your benefit application. A Social Security Representative may contact you or your appointed representative directly if we need any additional documents or information.”

For hearings: “Appeal Under Review: A medical decision has been made and we are working to process your decision. A Social Security Representative may contact you or your appointed representative directly if we need any additional documents or information.”

What They Mean

“We have made a decision. We have decided whether or not we consider you disabled. We are not going to tell you the decision yet. We are sending your file to your local Social Security office. Then your decision will show up on the website or in a letter. Sometimes the website comes first, sometimes the letter comes first.”

What Happens Next 

If the decision is an approval look here: Everything No One Ever Tells You About Living on Social Security Disability

If you need to keep appealing, there are many things you can do to improve your chances, look here: 

💮 Improve Your New Application
💮 Improve Your Reconsideration
💮 Improve Your Hearing Appeal

If the decision is an approval, and you are applying for SSI, they will soon contact you for a financial interview, look here: How to Handle an SSI Interview (PERC)

If the decision is a denial, for an initial application, look here: How to Request Reconsideration

If the decision is a denial, for a reconsideration, look here: How to Request a Hearing Appeal

If the decision is a denial, for a hearing appeal, look here: Options Beyond Hearings 

Everything that has happened so far and everything that happens next: Complete Social Security Timeline

But Wait! There’s More!

A few other things that can happen:

Quality Review

Before they tell you the decision, they may send your file to an office called quality review where they will double check our decision. Most of the time, nothing happens at quality review. However, if quality review disagrees with the decision, there is a small chance they may send it back for more consideration.

Not all applications go to quality review, if yours does, you will see a message that says: “Your benefit application is currently under review for processing accuracy. Once the review is complete, we will continue processing your appeal. Once the review is complete, we will continue processing your benefit application.”

Your appeal is currently under review for processing accuracy. Once the review is complete, we will continue processing your appeal.

Medical Approvals

If you get a message that you were approved medically but they need to do a non-medical review. This is good news. It means you were approved. The non-medical is just an SSI financial review.

Decision Writers

For hearings, there is one extra step. After the judge, makes a decision, the judge will send the decision to some people called decision writers. The decision writers will write a long letter explaining the judge’s decision. Then they will send it back to the judge to sign.

Improving Your Chances

More things to know and do while applying for Social Security:

Collect and Read Your Medical Records

🌺 It can be extremely helpful to know what your records say. (Hint: Do not read visit summaries or online records. These are not your full records.)

Check Your Social Security File

🌺 Lost or missing records are unfortunately a common reason for denials. (Hint: For initial applications, your lawyer does not have electronic access to your file. The only way to find out for sure is to talk directly to the person handling your case at Social Security. For appeals, your lawyer can access your file and give you a copy).

Make Your Life a Little Easier

🌺 Tips for financial survival and a (slightly) easier life while you are applying.

Troubleshoot

🌺 Click here if you run into a problem with your application

Learn the Difference Between SSI and SSDI

🌺 This may make your life less confusing.

Check Your Date Last Insured (SSDI Only)

🌺 If you are applying for SSDI, you may wish to check your Date Last Insured. If it is coming up soon, you want to do everything possible to get the best medical evidence you can before that day arrives.

Make Plans for Your Student Loans

🌺 If you have federal student loans, you have some options. Look into this now, so you don’t have to worry about your backpay being garnished.

Tricky Questions

🌺 Questions that may come up at the doctor’s office while you are waiting.

Speed Up the Process

🌺 Ways to get a faster decision or faster first check.

Thanks for Reading

🌸 Art on this page by Robin Mead and Elizabeth D’Angelo.

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