Social Security Disability Benefits: The Application Process

The application process for Social Security disability benefits can take anywhere from a few months to several years to complete. This is partly because of the many steps involved, but also because of the many layers of government bureaucracy involved in the final decision.

There are several different steps involved in applying for Social Security disability, although you may not have to complete all of them to qualify. The following outline explains each step of the process, along with what to expect along the way.

Initial Application: This step involves filling out the initial paperwork for your Social Security disability claim, along with submitting required documentation such as medical records, X-rays, or letters of recommendation. In many cases, this paperwork will be requested directly from your medical provider by the DDS.

Reconsideration: The reconsideration process begins after your initial application for SSI is denied. At this stage, your case will be seen by a different SSI reviewer for analysis.

Administrative Hearing: If you’re denied at reconsideration, you have the right to appeal for an administrative hearing. At this point, your case will be reviewed by a judge who will grant a final decision.

Appeals Council: If your case is denied at an administrative hearing, you have 60 days to appeal to an appeals council. The appeals council will decide where your case goes from here, or if it is denied altogether.

If you’re applying for Social Security benefits on your own, each of these steps can seem overwhelming. The process becomes easier to digest if you’re able to break down each step and consider its implications on its own.

Step 1: Initial Application

Filing an initial application for any of these benefits can feel like a full-time job. You’ll need to accurately describe your condition on detailed government forms, submit doctor’s records, and complete a variety of questionnaires that will help the Social Security Administration build a case for, or against, your eligibility.

While many attorneys that represent SSDI/SSI cases offer to help once you’re denied, you may actually be better off getting an SSDI/SSI lawyer or attorney as you submit your initial application. An honest attorney’s guidance may prove helpful as you navigate the complex world of requirements, and at the very least, they can help you fill out forms, gather evidence, and submit your first round of paperwork.

If you complete the initial application for SSDI/SSI on your own, you’ll need to make sure you provide every detail and form they ask for, and in an efficient and timely manner. Failing to submit all required forms for your application could result in a delay or denial of your case.

Step 2: Reconsideration

Reconsideration is only a factor if your initial application for SSI benefits is denied. Once you receive a denial, you have 60 days to appeal by asking for a reconsideration of your case. At this point, your claim is sent to a different reviewer where it will be analyzed again.

According to the Social Security Administration, only 28% of applicants get approval for their Social Security benefits after their initial application. That leaves the other 72% to accept their denial or apply for reconsideration. The percentage of applicants who were approved after reconsideration varied from 3% to 13% from 2000 to 2010.

Many people hire a lawyer or attorney to assist them at this stage of their claim. It’s important to note, however, that some states allow you to skip the reconsideration stage and proceed directly to the next step of the process, the administrative hearing. States that don’t have a reconsideration stage include Alaska, Alabama, Colorado, Louisiana, Michigan, Missouri, New Hampshire, New York, Pennsylvania, and some regions of California.

Step 3: Administrative Hearing

If your reconsideration is unsuccessful, or if you live in a state where reconsideration isn’t offered, you’ll need to move to the next step of the process: the administrative hearing. During this stage of your SSI application, you’ll have 60 days to appeal the last decision made in your case.

At this stage, your claim is assigned to an administrative law judge who will analyze your case independently and rule on your eligibility. Most of the time, these cases will be held within 75 miles of your home so you can attend in person. Having an SSI attorney on your side could prove helpful at this stage of the process, although many SSI applicants choose to represent themselves.

To prepare, you should gather any additional information for your case that has come to light since you filed your initial application for Social Security disability benefits. This information should include any new doctors you have seen, new hospitals visited, or medical treatments or tests that have been administered. You’ll also want a list of current medications you’re taking, along with any changes in your medical history that have taken place. Other supporting documents such as forms, medical reports, and written statements should be gathered before your administrative hearing date arrives.

During your administrative hearing, you’ll have the opportunity to state your case to the judge who will make the final decision. Since many more claims find success and approval at this stage compared to reconsideration, the administrative hearing is considered a crucial component of your application for Social Security disability benefits. At this point, you’ll need to have a full understanding of your medical condition or disability and be able to articulate how it prevents you from working and supporting yourself. Still, the Social Security Administration reports that approximately 53% of disability claims are ultimately denied.

Step 4: Appeals Council

If you’re among the majority who is denied Social Security disability benefits thus far, you’ll have another 60 days to file an appeal with the Appeals Council. At this stage, an appeals council will review your administrative hearing to determine if the judge assigned to your case followed the Social Security Administration’s rules and regulations in order to reach his or her conclusion.

One of three different outcomes can be expected once your case is in the hands of an appeal’s council. First, the decision may be reversed, granting you the Social Security disability benefits you applied for. Second, your case may be sent back to the judge who analyzed your case during your administrative hearing. Or third, the denial for your case will stand.

If you choose, you have the right to appeal your case all the way up to Federal Court.

The Bottom Line on Social Security Benefits

Applying for Social Security benefits seems daunting if you’re unfamiliar with the process. The complex web of paperwork, required medical visits, and the appeals process can make living with a disability or chronic condition infinitely harder at a time when you’re least able to cope.

The best thing you can do to ensure your case goes smoothly is to get organized. Keep careful records of your medical condition and continue seeing a doctor regularly so the Social Security Administration will have an ongoing record of your requests for care.

Once you begin your application for Social Security disability benefits, complete each form and step of the process completely and accurately. If needed, you can also hire an attorney who specializes in SSDI/SSI claims to assist with your case.


Article originally posted by The Simple Dollar and updated on January 11, 2017

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