Understanding the Social Security Disability Insurance Process

Many people suffer from disabilities and are unable to work, and some even face permanent or long-term disabilities. However, Social Security Disability benefits can provide help with the financial burden that comes with these disabilities; however, not everyone understands the process or how it works. Out of the millions of applicants each year, only about 30% receive approval at the initial application. The remaining 70% often have to go through the appeal process to better their chances of approval. The five stages of Social Security application and appeal process include the initial application, reconsideration, hearing, appeals council, and the federal district court. However, it is important to note that all applicants will have to go through the five stages since 30% receive approval on initial application.

The five stages in detail

Initial application - Making an initial application involves submitting your application along with appropriate medical evidence and any other relevant information. It takes about 90-180 days to complete this process; however, applicants who qualify for a Compassionate Allowance can receive an expedited processing of their claim. When applying, you will have to answer questions about your medical condition and work history. Also, you will be required to fill out an Activities of Daily Living Questionnaire. After submitting your medical evidence, you may need to undergo a consultative exam to confirm your disability and limitations. It is recommended you submit enough information regarding your disabilities to increase your chances of approval. The SSA also requires that your disability lasts for a period of 12 months or longer. Also, personal information like birth/baptismal certificate, doctors’ contact information, dates of hospital visits and stays, social security number, detailed work history will be requested. If the SSA decides that your claim satisfies the criteria, your application will be sent to the Disability Determination Services department for a full and final review.

Reconsideration - Denial of the initial application means you still have about 60 days to file an appeal for your claim. You will be required to send your application back to the SSA for reconsideration. Statistically, about 15% of appeals are approved during this stage. Expert opinion reveals that it is advisable to push an existing claim than to file a new one. Because the same operating rules apply, your claim may be denied again. However, at this stage, you can include any vital information you to help your chances of winning. Most applicants find it beneficial to contact a Social Security disability attorney at this stage. This process may take about 3 - 6 months to complete. The letter of a decision issued to you will notify you on whether or not your application was successful, and the conclusion was reached.

Hearing - If the outcome is negative, you may have to request a hearing in front of an ALJ (Administrative Law Judge) within 60 days of receiving your letter of decision. As usual, if you fail to submit your application within 60 days you will have to start the process all over again. At this stage, the fate of application lies in the hands of the ALJ, not Social Security. The ALJ will request that you present your evidence along with any testimony that proves why your claim should be successful. While it is not mandatory, hiring a Social Security disability attorney will ensure that your case is offered proper hearing at the right time. You will receive details about the timing and schedule of the hearing about twenty before the actual date. It is important you submit whatever evidence you have in good time before the hearing to give the ALJ enough time for consideration. In some cases, the legal representative may ask the judge to make a decision about your case before the actual hearing of your case. Sixty percent of applicants receive approval during this stage.

Appeals Council - The Appeals Council stage takes about 180 days to process. Only about 2% of the applicants receive favorable responses. If you do not receive an approval at the hearing stage, you have about 60 days to file an appeal. The Appeals Council will often uphold the decision made by the ALJ; however, they may review how the decision made by the ALJ is in accordance with the law. If the Appeals Council finds that the decision made was contrary to the law, they will request for remand case. However, if they decide the judge made too many errors while reviewing your case then, they may proceed to approve your application. As usual, this process will only be made easier with the assistance of a legal representative.

Federal district court - If you feel you rightfully deserve disability benefits then, it is not wrong to push your case even at this stage. To file an appeal in the Federal District Court, you must be willing to pay a fee or request a waiver (if you are not financially capable). It is also important you file your case within 60 days of the Appeal Council decision. If you fail to make an application during this period, you will have to start the application all over again. It is advisable to have a lawyer represent you during this period as an oral argument might be necessary. The Court may decide to grant you your benefits, keep your case for an additional review or maintain the decision made by the SSA. It may take the Federal District Court a year or more to process a claim