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What is E-File Access?
Social Security has recently implemented a process for authorized representatives which allows them access to a claimant's electronic claim file/folder during the hearing phase of the case.
Because Social Security has gone paperless, all claims for Social Security Disability and Supplemental Security Benefits are electronic in nature.
The recent e-file access program will improve a representative's ability to effectively prepare their clients' claims for hearing. Access can be made to the electronic claim folder to determine what evidence exists and what additional evidence still may need to be submitted. Representatives can now access and review Social Security's internal documentation concerning a person's earnings record, the adjudicator's reasoning for denial of the claim, the consultative examination doctor's report prepared by the Social Security doctor, as well as all medical or other related evidence that Social Security obtained on their own. It also allows a representative to verify whether or not all evidence that he/she submitted to the claim folder successfully uploaded.
It is expected that Social Security will allow the representative to access the electronic claim file at the initial and reconsideration levels of a claim, however, this has not been implemented to date.
What if You Receive a Partially Favorable Decision?
First, we must understand the meaning of an onset date. An onset date is the date that a claimant's medical condition(s) become so severe that they are unable to continue working.
An alleged onset date is the date that a claimant believes is the date he/she became severe and could no longer work.
An established onset date is the date that an adjudicator, an attorney advisor reviewing claims for a hearing office or a judge determines is the date that a claimant could no longer work because of the severity of their medical condition(s).
A fully favorable decision is when Social Security agrees with the claimant's alleged onset date.
A partially favorable decision is when Social Security determines that the claimant became severe at a later time then the date alleged.
When a partially favorable determination is awarded, it may be accepted or it can be appealed. By accepting the decision, a claimant is very likely giving up additional back benefits that they rightly deserve and it may delay the commencement of Medicare coverage.
In a case where a claimant receives a partially favorable decision, and it is believed that the alleged onset date (which is the date the claimant stopped working) is, in fact, legitimate and supported by the evidence in file, then it is highly recommended that the partially favorable decision be appealed.
There are many pros and cons that must be considered before making your decision about whether or not to appeal the onset date. It is highly recommended that you seek the help of a qualified disability representative before making such a decision, so that you can be fully informed regarding all of the issues.