FULLY FAVORABLE DECISIONS

Fully favorable decisions are those which award the claimant everything he or she asked for. In a fully favorable decision, the claimant is found disabled from the date alleged in the application for benefits.  In other words, the "alleged onset date" stated in the application becomes the "established onset date" set by the judge or adjudicating officer.  The result is retroactive or back pay for the claimant.


A fully favorable decision will also provide access to Medicare coverage sooner.  A claimant becomes eligible for Medicare 24 months after his or her disability begins.  So, if your established disability onset date was January of 2010, you could receive Medicare in January of 2012.


A partially favorable decision finds the claimant to be disabled - but moves up the alleged onset date to a later date than alleged in the application.  For instance, a claimant states that he became disabled on June 10, 2009 but the administrative law judge finds the actual "established" onset date to be September 1, 2011.  The claimant cannot receive any back pay for the months prior to September 1, 2011.  Partially favorable decisions (onset date) can be appealed.


An unfavorable decision finds that the claimant is not disabled and is not entitled to any benefits under the Social Security Act.  If this decision is made by a state disability determination service, it can be appealed to a federal administrative law judge.  If the decision was made by an administrative law judge, it can be appealed to the Appeals Council.  If the Appeals Council made the unfavorable decision, it is subject to review by a US District Court.


60 days are allowed for appeals to be filed.  The 60 day period starts with the date you receive your decision letter.  Social Security assumes that you received the letter 5 days after it was mailed.  This gives you a total of 65 days to file an appeal on an unfavorable or partially favorable decision.

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