Claims Designated as “Critical” at the Hearing Level (Dire Need)

January 14, 2016

The wait for a hearing with the Office of Disability Adjudication and Review (ODAR) can be a long one. We hope for quick hearing dates but often must wait until the judge sets it up on his or her calendar and that can take months. Presently, in the Cleveland ODAR office, claimants can expect a hearing approximately sixteen months after a hearing is requested. Columbus, Cincinnati, Pittsburgh and Indianapolis wait times are similar. In certain cases, however, ODAR identifies claims as “critical” so that they are expedited. Critical cases are those where:

•    a claimant's illness is alleged or identified as terminal (i.e., untreatable, irreversible, and expected to end in death); •    a claimant has received a 100 percent permanent and total (100% P&T) disability compensation rating from the Department of Veterans Affairs (VA);•    the claim involves any current or former member of a military service who sustained an illness, injury, or wound while on active duty status on or after October 1, 2001; •    a claimant’s condition(s ) is so severe that it would obviously meet Social Security's definition of disability (referred to as “Compassionate Allowances”);•    a claimant alleges any of the following circumstances–he or she is without food and is unable to obtain it, lacks medicine or medical care and is unable to obtain it or lacks shelter (i.e., dire need);•    there is an indication that the claimant is suicidal, homicidal, or potentially violent.

The hearing office will assign critical cases for on-the-record (OTR) decision review. If an OTR decision is possible, the case will be assigned to a decision-writer for expedited writing of the favorable decision. If an OTR decision is not deemed appropriate, the hearing staff will take appropriate action to expedite pre-hearing development and schedule a hearing in the first available open hearing slots. After the hearing is held, the ALJ will issue a decision in an expedited manner.

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