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Case Processing Flowchart

Logowhite

CPC

Click on chart to enlarge.

No matter what adjudicative level you're on in the disability process, (initial, reconsideration or Administrative Law Judge), the advocate's actions in processing the case are basically the same. 

These processing steps are:

Interview Client

The assessment phase:  In this first step, you must determine if the case is worth accepting.  This can be done by interviewing the client and manually or automatically assessing the case using the  Navigator program.  If the case has at least a 70% chance of being won, you can consider accepting the case.  If you accept the case, you must begin the process of signing on the client.

Acceptance or Intake Phase:   This process involves the exchange and completion of forms by the claimant.   These forms include your instructions to the client, your contract with the client and the required Social Security forms like the 1696.

Case development: During this phase, you must collect as much medical and vocational information about your client as possible.  These medical records are used in the case evaluation process.   How much case development you do depends upon the adjudicative level of the case.   On the Initial level, you can expect to do the most case development.  Less development is needed on the Reconsideration level and less still at the ALJ.

Case evaluation: Once you have your client's medical records, this phase begins.  In this phase, you review the evidence and create an argument on behalf of your client.  It is during the case evaluation process that you apply the sequential analysis, vocational analysis and physical limitation techniques as discussed in your training program.

Argument Creation: Your argument or brief is then submitted to Social Security and becomes part of the client's file.  Social Security must consider your argument before making a final decision in the case.  This Social Security review requirement can significantly improve a client's chances of receiving benefits. 

Submission of argument to SSA

This process is explained in your training materials.

Decision

You and the client should receive a decision notice from Social Security. 

Billing

Only if the case is allowed.


 

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