We know that the Social Security disability application and appeal processes are confusing. In order to answer the most common questions, we have created this FAQ page to provide you with general information about Social Security disability. We make every effort to provide accurate and current resources, but because each individual circumstance is unique you must not rely on this general information as factual for your specific situation.
There is no substitute for the advice of a competent attorney or advocate. For a no-cost/no-obligation review of your case, please complete this simple form by
clicking here. You will be contacted quickly by a Social Security attorney or advocate.
SOCIAL SECURITY DEFINED
- What is Social Security?
Answer: The Social Security disability insurance program pays benefits to people (or certain family members) who cannot work because they have a medical condition that is expected to last at least one year or result in death. Federal law requires this very strict definition of disability. While some programs give money to people with partial disability or short-term disability, Social Security does not. To qualify, you must have worked a certain period of time and paid Social Security taxes.
- What is Supplemental Security Income (SSI)?
Answer: The SSI program makes payments to people with low income who are age 65 or older, are blind, or have a disability. The Social Security Administration manages the SSI program. Even though Social Security manages the program, SSI is not paid for by Social Security taxes. SSI is paid for by U.S. Treasury general funds, not the Social Security trust funds.
- How does the Social Security Act define "disability"?
Answer: For all individuals applying for disability benefits under the Social Security disability insurance program (title II), and for adults applying under the Supplemental Security Income program (title XVI), the definition of disability is the same. The law defines disability as the inability to engage in any substantial gainful activity (SGA) by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.
Under title XVI, a child under age 18 will be considered disabled if he or she has a medically determinable physical or mental impairment or combination of impairments that causes marked and severe functional limitations, and that can be expected to cause death or that has lasted or can be expected to last for a continuous period of not less than 12 months.
Learn more here.
- Who makes the initial Social Security Disability Insurance or Supplemental Security Income decision?
Answer: At the initial stage of approval a DDS examiner makes the disability determination decision. The DDS is the state-level agency which decides claims that are filed through the Social Security Administration. A DDS Examiner Level II also makes the reconsideration level decision. However, at the third stage, a hearing is held before an Administrative Law Judge who will make the decision after hearing testimony.
QUALIFYING FOR BENEFITS
- How do I know if I will qualify to receive Social Security disability benefits?
Answer: There is no way to know with 100% certainty whether your will qualify for benefits. However, if you are unable to perform gainful work due to a disability, and/or your disability is included on the SSA List of Impairments, then you may qualify. A knowledgeable
advocate or attorney will be able to review your claim and provide you with a general idea of how your evidence supports your case. Unfortunately, until your claim has been approved, there are no guarantees.
- Do I have to be permanently disabled to qualify for Social Security disability benefits?
Answer: No, you do not have to be permanently disabled. To
qualify for Social Security disability benefits you must have a disabling condition that has lasted, or will last, for longer than 12 months or cause death within a year.
- How does the Social Security Administration decide if I can receive disability benefits?
Answer: The SSA uses a
five-step process to decide if you are disabled.
1. Are you working?
If you are working and your earnings average more than a certain amount each month (currently $980/month), they generally will not consider you disabled. The amount changes each year. For the updated figure, see the annual Update (Publication No. 05-10003).
If you are not working, or your monthly earnings average the current amount or less, the state agency then looks at your medical condition.
2. Is your medical condition "severe"?
For the state agency to decide that you are disabled, your medical condition must significantly limit your ability to do basic work activities-such as walking, sitting and remembering-for at least one year. If your medical condition is not that severe, the state agency will not consider you disabled. If your condition is that severe, the state agency goes on to step three.
3. Is your medical condition on the List of Impairments?
The state agency has a List of Impairments that describes
medical conditions that are considered so severe that they automatically mean that you are disabled as defined by law. If your condition (or combination of medical conditions) is not on this list, the state agency looks to see if your condition is as severe as a condition that is on the list. If the severity of your medical condition meets or equals that of a listed impairment, the state agency will decide that you are disabled. If it does not, the state agency goes on to step four.
4. Can you do the work you did before?
At this step, the state agency decides if your medical condition prevents you from being able to do the
work you did before. If it does not, the state agency will decide that you are not disabled. If it does, the state agency goes on to step five.
5. Can you do any other type of work?
If you cannot do the work you did in the past, the state agency looks to see if you would be able to do
other work. It evaluates your medical condition, your age, education, past work experience and any skills you may have that could be used to do other work. If you cannot do other work, the state agency will decide that you are disabled. If you can do other work, the state agency will decide that you are not disabled.
- Can I work and receive benefits?
Answer: After you start receiving disability benefits, you may want to
try working again. There are special rules that help you keep your cash benefits and Medicare while you test your ability to work. These rules are called "work incentives" or "employment support" programs.
During the trial work period, there are no limits on your earnings. During the 36-month extended period of eligibility, you usually can make no more than $980 a month or your benefits will stop. But, the work expenses you have as a result of your disability are deducted when they count your earnings, to see if they can help you keep more of your benefits. If you have extra work expenses, your earnings could be substantially higher than $980 before they affect your benefits. This substantial earnings amount usually increases each year.
They deduct work expenses related to your disability from your earnings before the determine if you are still eligible for benefits. These expenses may include the cost of any item or service you need to work, even if the item or service also is useful to you in your daily living. Examples include prescription drugs, transportation to and from work (under certain conditions), a personal attendant or job coach, a wheelchair or any specialized work equipment.
- If I am disabled, does my family qualify for Social Security disability benefits?
Answer: Certain members of your family may qualify for benefits based on your work. They include:
- Your spouse, if he or she is 62 or older;
- Your spouse, at any age if he or she is caring for a child of yours who is younger than age 16 or disabled;
- Your unmarried child, including an adopted child, or, in some cases, a stepchild or grandchild. The child must be under age 18 or under age 19 if in elementary or secondary school full time; and
- Your unmarried child, age 18 or older, if he or she has a disability that started before age 22. (The child's disability also must meet the definition of disability for adults.)
NOTE: In some situations, a divorced spouse may qualify for benefits based on your earnings if he or she was married to you for at least 10 years, is not currently married and is at least age 62. The money paid to a divorced spouse does not reduce your benefit or any benefits due to your current spouse or children.
- I am presently a stay-at-home parent, but I used to work outside of the home. Can I qualify for Social Security disability benefits if I become sick or injured?
Answer: Maybe. If you have worked 5 out of the last 10 years before becoming disabled, or if you're under 31 and worked before becoming disabled you may qualify for benefits. If your earnings are low enough since you've been an at-home parent, then you may qualify for the Supplemental Security Income program (SSI).
- I have never worked at public work, but am disabled. Would I qualify for Social Security disability benefits if I become sick or injured?
Answer: Maybe. You may qualify for Supplemental Security Income (SSI), which is different from the Social Security disability benefit program. The SSI program doesn't consider a person's work history or earnings record.
- I am a disabled widow, and I haven't worked at public work for many years. Can I receive Social Security disability benefits?
Answer: Maybe. If you're over 50 and became disabled within 7 years of your spouse's death, then you may qualify for Disabled Widow's benefits. You may also qualify if you are over 50 and became disabled within 7 years of your last check from your parent's Social Security benefits. Another way you may qualify is if your earnings and possessions are low enough to create eligibility for SSI benefits. This program doesn't consider your age, date of disability or work history.
- My daughter has been disabled since birth and is unable to work. Would she qualify to receive Social Security disability benefits?
Answer: Very possibly. If your daughter is under 18 years of age, is disabled, you're your household meets the SSA's poverty requirements, she could qualify for a child's Supplemental Security Income (SSI). If your daughter is over age 18, she may qualify for adult SSI benefits, which wouldn't consider the parent's income when making the decision. If a child's parents are disabled or deceased, the child may also be eligible for Disabled Adult Child Benefits.
- I am disabled from an auto accident. I plan to return to work after I recover. Do I qualify for Social Security disability benefits?
Answer: If you believe that you will be disabled for longer than 12 months, than you may qualify for Social Security disability benefits and should apply regardless of whether you plan to work upon recovery. There is a 5-month waiting period for receiving benefits, and the process to receive an approval is lengthy, making it essential to file immediately.
- Can I qualify for Social Security disability and worker's compensation benefits at the same time?
Answer: Yes, you can, although either your Social Security benefits or your Worker's Compensation benefits may be reduced, depending on the state you live in. The combined amount of the two types of benefits may not exceed 80% of your average current earnings.
- I am 75% disabled. Can I get 75% of my Social Security disability benefits?
Answer: While some programs give money to people with partial disability or short-term disability, Social Security does not.
- I have several health conditions. Although the individual conditions don't disable me, the combination of these conditions causes me to be disabled. Do I qualify for Social Security Disability Benefits?
Answer: Yes, you may be considered disabled. The SSA will consider your overall condition, rather than just a single disabling condition. Social Security benefits are determined on the cumulative effect of numerous impairments, as well as independent disabilities.
- I have a disabling mental illness. Would my mental illness qualify me for Social Security disability benefits?
Answer: If the SSA determines that you have a medically determinable mental impairment that has lasted or is expected to last for a continuous period not less than 12 months that makes it impossible for you to engage in any substantial gainful activity, than you may qualify for benefits. Your impairment does not have to be physical in nature.
- Is Alcoholism or Drug Addiction considered a disability?
Answer: No, the current Social Security Act now prohibits disability benefits based on disabilities related to alcoholism or drug addition.
APPLYING FOR BENEFITS
- Can I apply for Social Security disability benefits if I am a stay-at-home parent?
Answer: Maybe. If you have worked 5 out of the last 10 years before becoming disabled, or if you're under 31 and worked before becoming disabled you may apply for benefits. If your earnings are low enough since you've been an at-home parent, then you may apply for the Supplemental Security Income program (SSI).
- If I plan to return to work after I recover from my auto accident injury, should I still apply for Social Security disability benefits?
Answer: If you believe that you will be disabled for longer than 12 months, than you should apply for Social Security disability benefits, regardless of whether you plan to work upon recovery. There is a 5-month waiting period for receiving benefits, and the process to receive approvals is lengthy, making it essential to file immediately.
- I am presently receiving worker's compensation benefits. Do I have to wait until this compensation ends to apply for Social Security disability benefits?
Answer: No, you can apply for Social Security disability benefits as soon as you are disabled. However, either your Social Security benefits or your Worker's Compensation benefits may be reduced, depending on the state you live in. The combined amount of the two types of benefits may not exceed 80% of your average current earnings.
- Can I apply for Social Security disability benefits immediately after becoming disabled, or do I have to wait to apply?
Answer: If you are disabled and unable to work, and also believe you may qualify for Social Security disability benefits, you should file a social security disability or SSI application as soon as you are eligible.
Most claimants will be eligible to file a disability application the day after they stop working or the day after their earnings drop below $980.00 per month.
- Can I apply for Social Security disability benefits even if I am not permanently disabled?
Answer: Yes, you do not have to be permanently disabled to apply for benefits. To
qualify for Social Security disability benefits you must have a disabling condition that has lasted, or will last, for longer than 12 months or cause death within a year.
- I am out of work on Sick Leave. Do I have to wait until I have used all of my sick leave to apply for Social Security disability benefits?
Answer: No, you should apply for Social Security benefits as soon as you feel that you qualify, as the process of approval can take up to 3 years (if an appeal is necessary) and you will not receive payment until 5 months after your approval.
- How does Social Security decide if an applicant is disabled?
Answer: The SSA will review your application to make sure you meet some basic requirements for disability benefits. They will check whether you worked enough years to qualify. Also, they will evaluate any current work activities. If you meet these requirements, they will send your application to the Disability Determination Services office in your state.
This state agency completes the disability decision for the SSA. Doctors and disability specialists in the state agency ask your doctors for information about your condition. They will consider all the facts in your case. They will use the medical evidence from your doctors and hospitals, clinics or institutions where you have been treated and all other information. They will ask your doctors:
- What your medical condition is;
- When your medical condition began;
- How your medical condition limits your activities;
- What the medical tests have shown; and
- What treatment you have received.
They also will ask the doctors for information about your ability to do work-related activities, such as walking, sitting, lifting, carrying and remembering instructions. Your doctors are not asked to decide if you are disabled.
The state agency staff may need more medical information before they can decide if you are disabled. If more information is not available from your current medical sources, the state agency may ask you to go for a special examination. They prefer to ask your own doctor, but sometimes the exam may have to be done by someone else. Social Security will pay for the exam and for some of the related travel costs.
- What is the process to apply for Social Security disability benefits?
Answer: This complex process and the approximate deadline and decision times can be found by
clicking here.
- What steps should I take to apply for Social Security disability benefits?
Answer: Again, this can be a complicated process. Learn more about how to apply correctly by
clicking here.
- What kind of evidence do I need to gather to support my claim?
Answer: The
information the Social Security Administration needs includes:
- Your Social Security number;
- Your birth or baptismal certificate;
- Names, addresses and phone numbers of the doctors, caseworkers, hospitals and clinics that took care of you and dates of your visits;
- Names and dosage of all the medicine you take;
- Medical records from your doctors, therapists, hospitals, clinics and caseworkers that you already have in your possession;
- Laboratory and test results;
- A summary of where you worked and the kind of work you did; and
- A copy of your most recent W-2 Form (Wage and Tax Statement) or, if you are self-employed, your federal tax return for the past year.
- In addition to the basic application for disability benefits, there are other forms you will need to fill out. One form collects information about your medical condition and how it affects your ability to work. Other forms give doctors, hospitals and other health care professionals who have treated you permission to send us information about your medical condition.
- How can I speed up my claim?
Answer: The most effective method to speed your claim is to be properly prepared and avoid
common mistakes. If you are thorough in collecting all of the required
documents, medical records and evidence, doctor's statements and other required paperwork; you will reduce the chance of delaying your claim due to missing paperwork or technicalities. Other ways that you can improve your processing speed are:
- Stay knowledgeable about the status of your claim by making periodic calls to your assigned examiner at Disability Determination Services.
- Make sure that you meet all deadlines. Respond immediately to any time-sensitive requests by the examiner.
- Keep your disability examiner current on any recent medical treatments.
- Immediately report any changes of important information to your disability examiner. Changes of address, phone number, treatment sources, diagnoses and other pertinent facts should be communicated immediately.
- Why does Social Security consider my age to determine if I am disabled?
Answer: Age is considered as a determinant in what type of work you may be able to perform. The SSA looks at things that go along with getting older, such as reduced vision, weakened hearing, stiffer joints and reduced hand-eye coordination. The more a claimant has deteriorated due to advancing age, the more important of a role age will play when determining a claimant's disability.
GENERAL
- Is there a list of illnesses or impairments that Social Security considers are disabling?
Answer: Yes, the SSA publishes a listing of impairments that the administration views as "disabling." An overview of impairments that may be considered a disabling condition can be found in
our Glossary of Common Disabilities and Impairments. The entire SSA list, and descriptions of these impairments can be found on the SSA.gov website,
http://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm.
- If I am approved for Social Security disability, how far back will they pay benefits?
Answer: If your claim for Social Security disability benefits is approved, you can receive back pay from the time that you filed their application, and as much as 12 months retroactive to this date (bear in mind, this is the maximum and the actual amount received will depend on date that the SSA decides your disability began and the date of entitlement.) Due to the five-month waiting period, entitlement is defined as a claimant's first month of eligibility to receive benefits.
An individual whose application was for SSI can receive back pay from the date of their application and not before. There are no retroactive benefits for SSI.
- How can I improve my chances of winning approval for my Social Security disability claim?
Answer: Hiring a qualified representative such as an advocate or attorney is one vital way that you can improve your chance of winning approval for your claim. Statistics show that your chances of initial approval without representation are approximately 30%. The majority of claims submitted with the help of a representative are approved at the initial stage.
Should you choose to file on our own there are several ways to help your case:
- Stay knowledgeable about the status of your claim by making periodic calls to your assigned examiner at Disability Determination Services.
- Make sure that you meet all deadlines. Respond immediately to any time-sensitive requests by the examiner.
- Keep your disability examiner current on any recent medical treatments.
- Immediately report any changes of important information to your disability examiner. Changes of address, phone number, treatment sources, diagnoses and other pertinent facts should be communicated immediately.
- How long does the Social Security disability application and approval process take?
Answer: The length of time it takes to receive an initial decision on your disability claim is from 3 to 5 months. It can vary depending on several factors, but primarily on:
- The nature of your disability;
- How quickly the SSA obtains medical evidence from your doctor or other medical source;
- Whether it is necessary to send you for a medical examination in order to obtain evidence to support your claim; and
- If your claim is randomly selected for quality assurance review of the decision.
However, throughout the U.S. the initial application and the appeals process is
getting longer due to a growing number of claims in the system and the entire process can take in excess of two years. There is no way to accurately predict how long it may take to settle a claim. If your initial application is
denied, the reconsideration process can take approximately 6 months. If your claim is denied at this level, an appeal hearing can be scheduled. This may take as long as 18 months for scheduling alone.
- How much money will I get if I get approved for Social Security disability benefits?
Answer: The amount of your monthly disability benefit is based on your average lifetime earnings. The Social Security Statement that you receive each year displays your lifetime earnings and provides an estimate of your disability benefit. It also includes estimates of retirement and survivors benefits that you or your family may be eligible to receive in the future.
- When do my benefits begin?
Answer: If your application is approved, your first Social Security disability benefits will be paid for the sixth full month after the date your disability began.
Here is an example: If the state agency decides your disability began on January 15, your first disability benefit will be paid for the month of July. Social Security benefits are paid in the month following the month for which they are due, so you will receive your July benefit in August.
- How long will my Social Security disability benefits last?
Answer: Your
disability benefits will continue as long as your medical condition has not improved and you cannot work. Your case will be reviewed at regular intervals to make sure you are still disabled. If you are still receiving disability benefits when you reach full retirement age, they will automatically be converted to retirement benefits.
- Can I receive Social Security benefits if I'm disabled, but not poor?
Answer: The Social Security disability insurance program (Title II) provides for payment of disability benefits to individuals who are "insured" under the Act by virtue of their contributions to the Social Security trust fund through the Social Security tax on their earnings, as well as to certain disabled dependents of insured individuals. These benefits are not restricted to only those with limited income and resources.
- Are there different types of Social Security disability benefits?
Answer: The Social Security Administration (SSA) administers
two programs that provide benefits based on disability: the Social Security disability insurance program (title II of the Social Security Act (the Act)) and the supplemental security income (SSI) program (title XVI of the Act).
Title II provides for payment of disability benefits to individuals who are "insured" under the Act by virtue of their contributions to the Social Security trust fund through the Social Security tax on their earnings, as well as to certain disabled dependents of insured individuals. Title XVI provides for SSI payments to individuals (including children under age 18) who are disabled and have limited income and resources.
Under the Social Security disability insurance program (title II of the Act), there are three basic categories of individuals who can qualify for benefits on the basis of disability:
- A disabled insured worker under full retirement age.
- An individual disabled since childhood (before age 22) who is a dependent of a parent entitled to title II disability or retirement benefits or was a dependent of a deceased insured parent.
- A disabled widow or widower, age 50-60 if the deceased spouse was insured under Social Security.
Under title XVI, or SSI, there are two basic categories under which a financially needy person can get payments based on disability:
- An adult age 18 or over who is disabled.
- A child (under age 18) who is disabled.
HIRING REPRESENTATION
- Who can I go to for help with my Social Security disability claim?
Answer: The
www.SSA.gov website is the Social Security Administrations resource site with help for individuals interested in filing a Social Security disability claim. They also have representatives available by phone to answer questions, or you may set an appointment to discuss your claim in person.
However, your best alternative for assistance in filing a claim is to contact an attorney or advocate. We offer a free evaluation service where an advocate or attorney will review your claim information to see if they can be of help with your case.
Click here to complete the simple form to get you started.
- Where can I find an attorney or advocate to represent me with my Social Security disability claim?
Answer: Our free evaluation service will collect important information about your claim and will put you in touch with a professional advocate or attorney in your area that specializes in your type of case. These experts will contact you quickly to discuss your case further.
Click here to learn more.
- Do I need a lawyer or advocate to represent me with my Social Security disability claim? Can I handle it myself?
Answer: No one is required to have representation when applying for Social Security disability or SSI, and there are resources available to assist you in filing your own claim. However, the majority of self-filed claims are initially denied, and the
appeal process can take over 2 years. In order to file all paperwork properly, meet all deadlines, provide the necessary evidence to support a claim, and increase the chances of approval, many individuals decide that disability representation is a wise idea. Even if filing your own claim, it is never a good idea to bring a Social Security disability case before an Administrative Law Judge without
qualified representation.
- What will an attorney or advocate do for me?
Answer: An attorney or advocate will properly complete initial paperwork and the complex appeal documents should they be needed, to prevent denials based on technicalities. They will gather all medical records, and get necessary statements from physicians. Representatives will analyze all previous decisions in an effort to strengthen the argument at the appeal level. They will frequently check the status of disability cases with the SSA.
- How does a disability lawyer or advocate prepare for a case?
: To prepare your case, an advocate or attorney will carefully review the details of your case. They will gather evidence from your doctor and ask the critical questions to best assemble the facts of your case. A representative will make sure that you have all proper documentation and that the initial application is filled out completely and properly, so that there will be no delays or rejections based on the application itself.
Should your case need to go to an
appeal stage, they will file all necessary appeal paperwork. They may refer you to additional doctors to strengthen your case, and will supplement your claim with updated records. They will prepare for questions and topics that will be reviewed at the appeals hearing and address any concerns prior to the hearing. They will subpoena any necessary witnesses to prove your claim. They are critical during the hearing to open, close, cross-examine witnesses and experts and to review and reassess any prior claims. They will also verify that any benefits are calculated correctly.
- Will a disability attorney or advocate do all of the paperwork for me?
Answer: Yes, if you choose to
have a representative assist you with your case, they will complete all paperwork on your behalf, as well as handle the submission to the SSA. You will not be required to stand for long waiting periods at the SSA office to submit your case paperwork.
- Do I need a disability attorney or advocate for only the disability hearing?
Answer: It is strongly advised that you have an attorney or advocate represent you at a disability hearing. However, hiring representation before you file your initial claim can significantly increase your chances of receiving an initial approval on your claim and avoiding the complex and lengthy appeal process.
- If I hire an attorney or advocate to represent me, what are their fees and how are they paid?
Answer: Advocates and attorneys are typically only paid if you win your claim and the Social Security Administration grants approval. After your claim is approved, you will receive a check for retroactive benefits that cover the months that your case was pending approval. Upon your claim's approval, the SSA will withhold the smallest of either 25% or $5,300.00 from your retroactive check and will then send this fee money directly to your lawyer or advocate, paying your fee.
DENIALS AND APPEALS
- What is the chance that my claim will be denied?
Answer: Current approval rates are typically under 30%, showing that the large majority of claims are initially denied and will need to go through the
appeals process, which can easily take up to 3 years to complete.
- Why are so many Social Security disability claim applications denied?
Answer: There are many reasons why the SSA rejects so many claims. In some cases it is because forms are not filled out correctly, or the proper documentation is not included. Sometimes, claimants get frustrated by the process and don't continue through the appeal process and fight to have their claim approved. In many cases, it is a matter of how difficult it is to prove that a disability exists with the SSA's very strict definitions what constitutes a disability. A lawyer or advocate can significantly increase the chance that your claim will be approved. Find out more
here.
- What should I do if my claim for Social Security disability benefits is denied?
Answer: If you wish to appeal, you must make your request in writing within 60 days from the date you receive your denial letter. The SSA assumes you receive the letter five days after the date on the letter, unless you can prove you received it later. Call your local Social Security office if you need help with your appeal. However, your chances of winning an appeal increase significantly with the help of a qualified advocate or attorney.
Click here for further information.
- Is it better to appeal my Social Security disability case, or to start over again with a new application?
Answer: In almost every case, it is always better to appeal your claim rather than start over with a new application. If you simply fill out a new application, it will probably be denied a second time. If you follow through the system of appeals, you can get your case heard by a judge. The hearing stage is where most people get their best chance of getting approved for benefits. If you simply file a new application, you give up your appeal rights and need to start the long process all over again.
- Is there a time limit to file for an appeal if my case is denied?
Answer: Yes, regardless of what level you are on in the process, you will always have 60 days from the date of your denial to file your appeal.
- What does "reconsideration" mean?
Answer: Reconsideration is a complete review of your claim by someone who did not take part in the first decision. They will look at all the evidence submitted when the original decision was made, plus any new evidence.
Most reconsiderations involve a review of your files without the need for you to be present. But when you appeal a decision that you are no longer eligible for disability benefits because your medical condition has improved, you can meet with a Social Security representative and explain why you believe you still have a disability.
- Do I have to go through the reconsideration process?
Answer: Yes, reconsideration is the first level of the appeal process. Only after receiving the reconsideration decision, may you ask for a hearing.
- Who determines whether my claim will be reconsidered?
Answer: Everyone who files paperwork for a reconsideration of their claim will have their claim put before an Administrative Law Judge for reconsideration review.
- How long does it take for Social Security to make a reconsideration decision on my claim?
Answer: It takes approximately 3 months to receive a decision once an your initial claim is filed. You must file for reconsideration within 60 days. It can take another 3 months to receive a decision after the reconsideration. The total process time to receive a decision at the reconsideration state is approximately 8 months, but can be significantly longer based on the current backlog of cases. Learn more about the application and appeal process.
- What are my chances of getting my claim approved after an appeal hearing with an Administrative Law Judge?
Answer: Nationally, more than half of all claims for disability benefits with the social security administration are won at the Administrative Law Judge hearing level.
- Can I appeal further if my claim is denied after reconsideration?
Answer: If you disagree with the reconsideration decision, you may ask for a hearing. An Administrative Law Judge who was not involved in the original decision or the reconsideration of your case will conduct the hearing. The hearing is usually held within 75 miles of your home. The administrative law judge will notify you of the time and place of the hearing.
Before the hearing, you may be asked to give more evidence and to clarify information about your claim. You may look at the information in your file and give new information.
At the hearing, the administrative law judge will question you and any witnesses you bring. Other witnesses, such as medical or vocational experts, also may give us information at the hearing. You or your representative may question the witnesses.
In certain situations, we may hold your hearing by a videoconference rather than in person. You will be notified ahead of time if this is the case. With video hearings, the SSA can make the hearing more convenient for you. Often an appearance by video hearing can be scheduled faster than an in-person appearance. Also, a video hearing location may be closer to your home. That might make it easier for you to have witnesses or other people accompany you.
It is usually to your advantage to attend the hearing (in person or video conference). You and your representative, if you have one, should come to the hearing and explain your case.
If you are unable to attend a hearing or do not wish to do so, you must explain this in writing as soon as you can. Unless the administrative law judge believes your presence is necessary to decide your case and requires you to attend, you will not have to go. Or they may be able to make other arrangements for you, such as changing the time or place of your hearing. You have to have a good reason for them to make other arrangements.
After the hearing, the judge will make a decision based on all the information in your case, including any new information you give. You will be sent a letter and a copy of the judge's decision.
- What is the Appeals Council?
Answer: The Appeals Council is the reviewing board to Administrative Law Judge decisions.
- How soon can I get a hearing on my claim?
Answer: It can take anywhere from 3 months to a year after you request a hearing to get your hearing scheduled depending on the backlog of cases in your area. Learn more here about the
social security backlog.
- What are my chances of getting my claim approved at the hearing stage?
Answer: Your changes of winning your claim at the hearing stage are approximately 50%.
- Can I appeal my case to the Federal Court?
Answer: If the Appeals Council denies your claim, it is possible for you to file a civil action suit in the U.S. District Court to review Social Security's decision. Although rare, every one to two years, the U.S. Supreme Court will hear a Social Security disability case appeal.
- What can I do if Social Security notifies me that they are going to cut off my benefits?
Answer: You can appeal the SSA's decision to end your disability benefits within 10 days of receiving the notification letter. If you do not appeal in that timeframe you might lose your right to appeal.
- Does Social Security continue to review my case to see if I am still disabled?
Answer: Yes. Your case will be reviewed at regular intervals to make sure you are still disabled.
- My doctor has verified that I am disabled, but Social Security has denied my claim - why?
Answer: Social Security makes a determination of your disability independently of your doctor's position. The SSA has a very specific definition of what constitutes a disability and requires "medically acceptable clinical and laboratory findings" as evidence. Many disabling conditions are difficult to diagnose objectively. Additionally, your doctor may define a disability in a different manner than the SSA.
- The VA has determined that I am disabled, so why has the Social Security Administration denied my claim?
Answer: The VA may consider a condition a disability, where the SSA definition will result in a different decision for that same condition. Also, VA decisions are not binding on Social Security.
- I am disabled and need help with my medical bills more than I need cash income. How can I get help for these medical bills?
Answer: In order to receive help with medical bills, you need to have received approval on a Social Security disability claim. Help with medical bills will begin after you begin to receive your cash benefits. These two benefits are tied together.
- If I get Social Security disability benefits, can I still receive Medicare?
Answer: Yes, after you are approved for SSDI benefits, you will receive automatic Medicare coverage two years after Social Security deems that your disability began.
- Will my Social Security disability benefits prevent me from receiving Medicaid?
Answer: No, it is possible to get both Medicare and Medicaid. If you receive Supplemental Security Income, you will get Medicaid. You may at the same time qualify for other types of disability benefits from Social Security at the same time.