Making the decision to apply for Social Security disability benefits is not an easy one. You have to consider the length of the process and come to terms with the fact that you just can’t physically or mentally work on a full-time basis anymore. For many people that is a difficult realization to come to. Knowing what to expect from the application process may help you make the decision as to whether you are ready to apply or not. Here is a general outline of what to expect from the process and the typical time frames:
1. Initial Application
There are three ways to submit an application for Social Security disability benefits. You can opt to have a phone interview with a Social Security Administration (SSA) employee, you can mail in a paper application, or the more popular way is applying online. I recommend applying online since you can do this from the comfort of your home, and you also receive a time-stamped paper confirmation of your application. This is important evidence to protect your application date in case your application is “lost” in the shuffle for some reason.
When getting ready to file your application make sure you have certain materials handy. This will make the application process go smoother. Here is a checklist of all the materials you should gather:
- Dates and locations of marriages and divorces
- Names, dates of birth, and Social Security numbers for minor children and spouse
- checking or savings account number
- Name and address of emergency contact person
- Name, address and phone number for any medical treatment you received after you stopped working full time
- List of medications you are currently taking
- Employment history for the past 15 years.
Once your application is filed, the SSA will process the application. They first check to make sure you meet the technical requirements of the program. If you do, then your case will be evaluated by the State for your medical eligibility. At which point, the State will develop the medical evidence required to make a decision in your case. This includes questionnaires regarding your pain levels, activities of daily living, contacting people who know you, and going through your past work. In addition to the questionnaires, the State will request copies of medical records from all the doctors, hospitals, and clinics you listed in the application. It is possible the State will have a doctor review the records to help make a disability determination, although this is not required.
Typically, you can expect this development process to take 3 to 4 months. Once a decision is made regarding medical eligibility the State transfers your case back to the local SSA office to process and mail out the decision.
2. Reconsideration Stage
If you receive a denial letter, which typically happens, then you will have 60 days to appeal the decision. Just because you received a denial letter does not mean that you are not disabled. It simply means the State did not have enough medical evidence to approve your case. Many people become discouraged and give up after the first denial. My best piece of advice is to appeal the decision and seek help from an experienced Social Security disability attorney. Having an attorney represent you not only shows SSA you mean business but also provides you with some guidance, so you understand what is normal and what is not throughout this process.
At the reconsideration stage, you are simply asking SSA to re-look at your case. The State will continue to develop your case for medical evidence and consider whether they made a mistake with their first decision. Your chances of getting approved at the reconsideration stage are even lower than at the first stage. So if you receive a denial again at this stage DO NOT GIVE UP!
3. Request a Hearing
If you receive a second denial, then you have 60 days to appeal that decision. At this point, you would request to have a hearing in front of a judge. The benefit of requesting a hearing is that the judge will get to see you face to face and is therefore not limited to only the paperwork surrounding your case. They will have a chance to hear your side of the story and frankly get a better picture of what is going on with you. If you don’t have an attorney at this point I strongly recommend you get one. Trying to go to a hearing on your own without having any experience with this process is extremely difficult. At the hearing, you will not only be able to give your side, but the judge may ask a medical expert and vocational expert to testify regarding your case. An experienced Social Security disability attorney will know how to cross-examine these experts. The attorney will also ensure your case is properly prepared and presented to the judge.
The downfall of having a hearing is that it takes approximately 12 months for it to be scheduled. Every state has different time frames, but the national average is 12 months. This is because when you put in your request for a hearing you are essentially given a number in line. Once your number comes up then the hearing office will give you the soonest available hearing date. It is possible in the most extreme circumstances to have your hearing expedited, but in that situation, you are essentially asking to be bumped in line in front of other people who are in similar situations.
4. Review by the Appeals Council
If the judge denies your case after a hearing it is possible to continue appealing your case. The next step would be to appeal the judge’s decision to the Appeals Council (AC). Again, you have 60 days to do this. The Appeals Council is an agency of the Social Security Administration that will review a judge’s decision for legal errors. The AC will not review every single case; they will simply review a case if there has been some type of legal error. If you are appealing for a factual reason or based on the judge’s interpretation the AC will more than likely refuse to hear the appeal.
The Appeals Council is similar to a black hole. When you submit your appeal, it takes them about 18 months to review the claim, and even when they review the claim there is never a guarantee that they will agree with you. In fact, more often than not, they side with the judge’s decision. Again, if you have not sought out an attorney to represent you, you should absolutely seek one out at this point. An attorney will be able to best advise you as to whether you have a good chance of appealing to the Appeals Council or not.
5. Review by Federal Court
If the Appeals Council refuses to review your case you can continue to appeal the decision up to Federal District Court. You are allowed to represent yourself in district court, but I absolutely do not recommend it. Once in district court, you can continue to appeal the case all the way up to the Supreme Court. As you can imagine, the time frames for this process are extremely lengthy.
So if you decide to submit an application for disability here are some closing thoughts:
- Don’t stop after your first denial
- Be prepared to appeal your case to at least the hearing level
- If you need to have a hearing be prepared for it to take approximately 1-2 years to get a resolution of your case
- Get an Attorney! Don’t waste time trying to figure out this complicated process on your own. Save yourself the stress and seek out someone who knows how to navigate this process.
