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Disability Claim: Cases
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Advice: Don’t give up on your claim until after you have reviewed your case with a disability lawyer. Disability lawyers know more about the law than SSA employees and give you correct information.
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Under the Administrative Procedures Act, disability claimants are entitled to a full and fair due process hearing. Federal administrative law judges provide that hearing. These cases can be very complex. This is not traffic court. The average award over a lifetime exceeds $250,000.
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As evidence, Shell said UnumProvident paid more than 90% of the 450,000 disability claims it received last year, at a cost of $4.2 billion. He said that in an additional 8% of cases, the firm did not pay because of what he described as technical reasons, as in cases where claimants returned to work before they became eligible for benefits. Only in the remaining 2% of cases or less — involving no more than 9,000 claimants — did the firm limit or deny benefits that led claimants to appeal.
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One IT project facing the prospect of reduced funding is the Accelerated Electronic Disability System, a complex redesign of SSA's disability claims process that will create an electronic folder for each case under review. The project's $103.2 million budget would be reduced to $73.5 million in fiscal 2005.
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Most disability contracts require claimants to apply for Social Security as a condition of receiving benefits under their employer-provided plan. In cases where claimants finally win Social Security benefits, the contracts give insurers the right to offset what they owe by the amount the government pays.
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