Social Security Disability Claims: Application Stages

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Elderly woman looks pensively at Social Security disability claim

Stages of a Social Security Disability Claim

By Ashley Baine
Attorney, PLF

A Social Security disability claim starts with an application at your local Social Security office or online at the Social Security website. At the application stage, Social Security will request records of all the places the person has received treatment. They will usually go back at least a year prior to the application date in getting records. If the medical records are not adequate to make a decision, Social Security will send the person for a one time physical or psychological evaluation or possibly both. Social Security will make a decision based on this evidence along with reports completed by the person for the application. Typically a decision will be sent out in two to four months. At the social security disability application stage, the approval rating is around thirty to thirty-five percent.

If denied, in most states the next stage is the reconsideration stage. At this stage in the Social Security disability process, Social Security will update the medical records and information from the person. The decision typically is sent out again around two to four months. At the reconsideration stage, the approval rating is around ten to fifteen percent.

If denied, the next stage is a social security disability hearing with an administrative law judge (ALJ). In some states, a person can skip the reconsideration stage and go straight to the hearing. Once a request for a hearing is made, it averages around twelve to eighteen months for the hearing office to schedule it. A hearing is where the ALJ will ask questions of the person to enhance the evidence already in the file. The medical evidence will also be updated again. A person can hire an attorney to assist at the hearing. The attorney will have a chance to ask their own questions to enhance the claim. After the hearing, it typically averages two to four months to receive a decision from the ALJ. The approval rating can vary wildly based on the ALJ assigned to the claim.

If denied at the hearing level, a person can appeal to what is called the Appeals Council. At this level, the ALJ’s decision is reviewed to determine whether all steps were followed in making the decision and substantial evidence supports it. The Appeals Council does not make a new decision on whether the person is disabled and they only accept medical records that are new and material to the timeframe the ALJ considered. Appeals Council can either overturn the ALJ’s decision and award benefits; send the case back to the ALJ to make a new decision with instructions on what needs to be done differently or find the ALJ’s decision was supported and allow it to stand. The Appeals Council overturns cases on average eleven to thirteen percent of the time.

Learn More About the Social Security Disability Process

If the Appeals Council declines to overturn the ALJ’s decision the case can be appealed beyond the Social Security Administration to the Federal District Court. At every stage, the person can hire a social security disability attorney to assist them with their claim. To learn more about the process go to the Social Security website ssa.gov.