The unfortunate reality of disability claims is that they can often some time to be processed. Social Security is often not forthcoming with claimants about the timeline of how these claims work, leading to frustration and confusion with the system. You may be wondering why your claim is taking so long and what is going on with it. We want to provide you with an explanation of the timeline of a disability claim so you know a bit more about what to expect.
Step One: The Application Stage
When you recognize that your disability is preventing you from working, the first thing you must do is apply for Social Security Disability benefits. This requires an extensive application process that describes what is preventing you from working, your medical treatment, and sometimes information about your finances or work history. We recommend seeking out an attorney to help you with this challenging step. Many attorneys will turn you away at the application stage, telling you to “come back when you have a denial.” Our office is unique in that we take the burden away from you at this stage; we go through the applications with you step by step and answer any questions you may have as this can be confusing and difficult.
After applying, we submit the application to the proper Social Security Administration office on your behalf via Certified Mail to ensure it arrives with proof of arrival. When it reaches the SSA office, they process it and inform our office and you that the claim has been received. Sometimes they may request that you fill out a form regarding work activity in which you have recently engaged. Once they receive everything they need, your claim goes on to Disability Determination Services (DDS). DDS is the department related to Social Security that evaluates the medical evidence in your claim. We report on your behalf any medical treatment you have been receiving. DDS will automatically order the relevant medical records. They may ask you to complete some questionnaires about your past work as well as how your disability affects your everyday life and restricts your activities. If they need more evidence, they may send you to a Consultative Examination free of charge. Then, DDS will make a recommendation based on the available evidence and forward your claim back to SSA. SSA will then make the final determination and issue a decision of either an approval or denial. If you are approved, you will soon receive benefits and the process ends here. If you are denied, you move on to the next stage. This stage usually takes between four to six months. Unfortunately, approximately 65% of claimants are denied at the application stage.
Step Two: The Request for Reconsideration
If you are issued a denial, our office appeals on your behalf as soon as possible and request that SSA reconsider your initial application. We will send you a form requesting updates about your medical records and any changes in your condition so that Social Security has new evidence to request to help substantiate your claim.
A request for reconsideration is very similar to the initial application stage, except your claim is evaluated by a different agent and disability adjudicator. SSA typically forwards your claim back to Disability Determination Services if you are issued a denial on the basis that SSA thinks you are able to return to work and thus not disabled. They go through the same process as above, gathering evidence about your disability and making a medical recommendation about with regards to the available medical evidence and doctors’ opinions. As with the application stage, the claim then goes back to SSA for the final determination. As this process is so similar to the application process, again it typically takes about four to six months. This stage is the most difficult to receive an approval, with approximately 85% of requests for reconsideration being denied. Again, our office appeals any denials on your behalf as soon as possible.
Step Three: Request for Hearing
At this stage, the appeal our office submits is actually a request for a hearing in front of an Administrative Law Judge. You can read more details about hearings here. First, our office will order any and all medical records regarding your disability to ensure that the judge has the opportunity to review the full history of the impacts of your disability. As the hearing approaches, you will meet with your attorney to discuss strategies for the hearing and to learn more about how hearings work. You and an attorney will appear in front of a judge and the attorney will advocate for your inability to work with medical evidence and legal arguments, supporting you every step of the way. Unfortunately, the office that handles hearings is quite backlogged, and the time frame between a request for hearing and the date the hearing actually takes place is typically 12-18 months.
Following the hearing, the judge will consider evidence and arguments from the attorney as well as any testimony you provided, at which point he or she will write a decision on your claim. The decision can be one of three things: a Fully Favorable, which means your claim was approved entirely; a Partially Favorable, which means some of your claim was approved; and an Unfavorable, which means your claim was denied. Hearing back from the judge typically takes about one to three months. Typically, the most success in claims is seen at the hearing level; having an attorney as your advocate is significantly helpful in giving the judge the information needed to make a decision in your favor. However, it is difficult to know a win rate because this varies based on individual judge and location. If you receive a Partially Favorable or an Unfavorable, our office will discuss your appeal options and see what direction you would like to go at this stage in the claim.
Stage Four: The Appeals Council
If you decide you want to appeal a hearing decision, our office will appeal to the Appeals Council on your behalf. This is a bit of a different process than the earlier appeals. When we appeal to the Appeals Council, we are stating that we believe SSA made a legal error in denying your claim. The Appeals Council can issue several different decisions: a denial as with earlier stages, an immediate payment of benefits (which is rare but does occasionally occur), or a remand to an Administrative Law Judge (this means that the Appeals Council means that SSA made a legal error in your claim and are sending the claim back to the judge for a new hearing. This part of the process also requires a wait of about one year until you hear back from the Appeals Council on a decision. Meanwhile, the attorneys will prepare for a possible denial at this stage and evaluate taking your claim to the next level – the United States District Court. Not all attorneys’ offices will take claimants to this level, so if your prior attorney will not, we welcome you to come and talk to our office about potentially taking your claim to USDC.
Social Security Disability claims can take significant time and energy in completing, making them very challenging for many disabled individuals. If you would like to hear more about how our office can help you every step of the way in your claim, please reach out to us to learn more at 855-503-0101 or e-mail us at info@evansdisability.com
