When you first file for benefits, you enter the initial application stage. The application consists of a lot of paperwork, often asking you the same questions many different times. A disability analyst reviews your medical records and decides whether or not you are disabled. The process, from start to finish, takes about four to six months.
If you are denied at the initial application stage, you may appeal the decision by requesting a hearing before an Administrative Law Judge (ALJ). Statistically, you have the best chance of winning when you appear at a hearing before an ALJ. It is the only time you have the opportunity to appear before the person who decides your case. Unfortunately, the waiting period for a hearing is lengthy due to tremendous backlogs in the SSA, and there is very little that you can do to decrease the waiting time.
If your case is denied by an ALJ, you may file an appeal with the Appeals Council. After a written appeal is submitted, a legal brief may be filed which argues why the ALJ’s decision was improper and should not be upheld. The Appeals Council can either grant or deny your case, or they may send it back to the ALJ for another hearing. The Appeals Council process is conducted entirely through paperwork, and is usually very lengthy as well.
If the Appeals Council denies your case, your only other option is to file a civil action in district court. At that point, you are no longer appealing to the SSA but to the federal courts. Therefore, strict legal rules apply and there are different standards. Filing a civil action can be costly, time-consuming, and demanding.
Things To Remember:
- Keep seeing your medical doctor while your claim is pending and after you are receiving benefits. Lack of treatment means lack of evidence to document your impairments.
- Keep track of all your medical providers, hospitalizations, and Emergency Room Visits and their contact information, and provide them to SSA or your representative if you have one, so they may collect all of your records.
- Notify SSA or your representative if you return to work while your claim for benefits is pending.
- If you change your address or telephone number, inform your Social Security office or your representative.
- The Social Security Administration will need to see your original birth certificate and proof of citizenship, so be sure to locate those documents. Copies will not be accepted.