When you get injured or are diagnosed with a disabling condition, that alone can be scary enough with the potential loss of a job and income and the pending treatment and recovery. Trying to navigate the complicated Social Security Disability system on your own can be a daunting task. Adding to that stress is the fact that once you file a Social Security Disability Claim, the process is very confusing with several steps and can seem to take forever. Many clients of mine tell stories of it taking several years for a family member or friend to get approved for benefits, while others proclaim family or friends have been approved in a mere matter of months. As a Social Security attorney for the last 20 years, I have experienced both sides of that spectrum more times than I can count. Why is there so much difference in processing times between different claims? In this blog, I will explore that issue and explain the Social Security Disability/SSI process.
The first step in the entire process is to actually file an application for Social Security Disability benefits or SSI benefits. Once an application is filed, it will take Social Security 4-6 months on average to decide the claim. During this 4-6 month period, Social Security will send you an Adult Function Report and a Work History Report to complete and they also may send you to see one of their doctors, which would be free of charge to you. Unfortunately, Social Security denies a very high percentage of application in this initial stage. Keep in mind, if you are denied at any stage in a social security claim, you only have 60 days with which to appeal that denial.
If you are denied after filing an application, the first appeal stage is called Request for Reconsideration. At this stage, clients are typically sent another Adult Function Report to complete and may be contacted via telephone by Social Security for information about updated doctors visits, medications or testing. We have been seeing a Request for Reconsideration take about 2-3 months to get a decision. Add that to the initial 4-6 months and most people who apply are denied on reconsideration after approximately 6-9 months. Unfortunately, again, most people are denied at this stage as it is essentially a rubber stamp denial of the previous denial on the application.
If you are denied on a Request for Reconsideration, the next step is to Request a Hearing before an Administrative Law Judge. We typically see it take 4-9 months to get a judge assigned and a hearing date. After the hearing, it will take an additional 2-3 months to get the decision in the mail. At this point, you are likely anywhere from 12-20 months into the process. The good news is that you have a protected filing date from the date you filed the application, so you can get back pay from the date you filed the application for SSI benefits and potentially back 8 months prior to filing the application for SSD benefits.
If you are denied at hearing, the last step in the process would be to Request Review of Hearing Decision with the Appeals Council and ask for an Appeals Judge to review the case. This can take an additional 6-18 months to get a decision.
If you are denied at the Appeals Council stage, you have exhausted what are known as your administrative remedies, meaning we have gone as far as we can within the actual Social Security Disability process. If you chose to appeal a denial by the Appeals Council, you would have to file a new lawsuit in the United States District Court and go through the District Court procedures, which are entirely different and separate from what I explained above.
As you can see, the time frames for each step of the process can vary for each claim with many claims even exceeding the time periods I reference above. Every claim is different and processing times do vary based on the complexity of the case, who the case was assigned to, whether one gets worker's compensation benefits, whether someone is still working, how quickly forms are completed and returned, and how long it takes to get the medical records and how many medical sources we need to get records from.
While the Social Security Disability and SSI process can seem daunting, having exceptional legal counsel maneuver through the system for you can make all the difference. If you have any questions about the above or want additional details, please do not hesitate to contact me.