Social Security Disability Process

Understanding the Social Security Disability Process

Filing an application for Social Security disability benefits is far from filling out and submitting a simple form. Rather, it is a complex, multi-step process that often begins with submitting an application that is accompanied by extensive documentation and continues through an extended process of denials and appeals. For most applicants, this process can take a year or more to complete.

Because of the length of time involved between the application for benefits and the actual receipt of benefits if approved, it is critical that you apply for benefits as soon as you become disabled. If your initial application is denied, and you have not yet hired an attorney to handle your claim, get a lawyer as soon as possible to proceed through the appeals process. Many people simply try to start over with a new application, thus returning to a pool of applicants from which nearly 75 percent are rejected, and starting the year-long wait all over from the beginning.

With only about a quarter of applicants receiving benefits approval at the initial application, it is clear that the majority of disability recipients must go through one or more of the subsequent steps in appealing a denial.

In most cases, the full disability application process involves the following steps:

  1. Application for Social Security Disability Benefits
  2. Request for Reconsideration
  3. Disability Hearing
  4. Appeal of an Administrative Law Judge Decision
  5. Continuing Disability Review

If your application for benefits is denied, it is time to begin the process of reconsideration and appeals. These steps are subject to requirements and deadlines that, if not met, will result in final rejection of your application. If you wish to obtain disability benefits after failing to request a reconsideration in a timely manner, for example, your case will be closed and you must start the entire process from scratch, further delaying your potential receipt of benefits.

This is one reason it is so critical to hire an experienced disability lawyer to handle your claim. Your lawyer will ensure that all forms and legal filings are properly completed and submitted and that they are filed within the designated allowable time limits. As you continue through a series of appeals, your attorney can offer quality legal representations in any hearings and proceedings.

SSD Application

The first step in the disability process is filing an initial application for benefits. This involves completing an application form that can be submitted online at the Social Security Administration website or obtained from your local Oklahoma Social Security office. The Oklahoma City field office is located in Shepherd Mall, 2615 Villa Prom, but other Oklahoma field offices located in Ada, Ardmore, Bartlesville, Chickasha, Clinton, Durant, Enid, Hugo, Lawton, McAlester, Miami, Moore, Muskogee, Okmulgee, Poteau, Shawnee, Stillwater, and Tulsa.

When you submit your application, you will also be required to provide identification and documentation of employment status and your disability:

  • Birth certificate
  • Social Security number
  • Medical records
  • List of medications and dosages
  • Results of lab tests and diagnostic tests
  • Contact information for health care providers, treatment facilities, and caseworkers
  • Summary of your employment
  • W-2 forms
  • Federal tax returns

Completing the application and compiling required documentation can be difficult for anyone not experienced with the process. Suffering a disabling medical condition can only complicate the matter further. By hiring a disability lawyer this early in the process, you allow an experienced professional to facilitate your application.

Over the last five years, an average of 2.8 million people applied for SSD benefits each year. Of that number, approximately 70 percent, or nearly 1.96 million people, are denied benefits. With an application filed by a well-qualified attorney, you maximize your chances of being among the 20-30 percent that receive benefits approval at the initial application.

If your claim, like millions of others, is rejected at this step, your attorney can quickly file the necessary request for reconsideration and handle any subsequent appeals.

Request for Reconsideration

It takes approximately 3 to 5 months for the Social Security Administration to review an application and respond to the claimant with an approval or denial. For millions of Americans, this first step will end in frustration, as the overwhelming majority of claims are denied upon application.

If the SSA reviews your application and decides to deny benefits, you will receive written notification of the denial. You may then file a request for reconsideration, but only an estimated 3 percent of applicants gain approval upon requesting reconsideration.

While it may have taken the Social Security Administration 90 to 150 days to review your application and make a decision, you have only 60 days from the receipt of a denial letter to request a hearing to demonstrate your disability.

If you have hired an attorney to handle your case from the beginning, he or she will be aware of the urgency and will promptly file the hearing request within the stipulated time frame. If you have not hired a lawyer to represent you, and you receive a written notice of denial, call a disability attorney as quickly as possible to allow time to consult with the attorney and get your hearing request filed within the 60 day window.

The Disability Hearing

The disability hearing is your chance to present your case before an Administrative Law Judge (ALJ) to demonstrate that your disability prevents you from obtaining or maintaining substantial gainful activity (SGA), and that the initial denial of your benefits was inappropriate.

The disability hearing is a legal proceeding, and like any serious legal matter, it is best handled by a competent attorney. In fact, if you attempt to represent yourself before the ALJ at the disability hearing, he or she is required by law to inform you that you have the right to seek legal counsel, and that your chances of obtaining an approval of benefits is increased with legal counsel and representation.

At the disability hearing, you will be able to present documentation of your disability and the limits it imposes on you. Your lawyer will gather documentation, evidence, and witnesses to support your claim that the severity of your disability prevents you from gainful employment.

The ALJ will look at the eligibility requirements and consider all evidence about the nature of the medical condition, the prognosis and expectation of further injury or recovery, your work history, and the impact your condition has on your ability to return to your job or to find other work.

Approximately 13 percent of applicants will receive approval of disability benefits at the hearing level.

If the ALJ affirms the denial of benefits, you may appeal the judge's decision.

Appeal of Denied Benefits

If an Administrative Law Judge finds that you do not qualify for SSD benefits, you may appeal his or her decision to the Social Security Administration's Disability Appeals Council. Just as you had only 60 days from the rejection of your application to file a request for reconsideration, you have only 60 days from the ALJ ruling to request a review by the Council.

When you file a an appeal of denied benefits, it is important to understand that the Disability Appeals Council will not review the evidence presented in your disability hearing, but rather, they will make a determination about errors or mistakes that the Administrative Law Judge may have made in reaching his or her decision.

Grounds for appeal of denied benefits include the following:

  • Substantive errors - For example, the ALJ does not examine the medical evidence provided in the case.
  • Technical errors - For example, the ALJ uses the wrong formula or applies the wrong rule in determining disability.
  • Insufficient evidence to support the ALJ ruling, in which any other judge would not reasonably come to the same conclusion.

Upon review of the appeal, the Council may take one of three actions:

  • Affirm the ALJ ruling to deny benefits
  • Reverse the ALJ ruling and approve benefits
  • Remand the case, or send it back to the ALJ with specific instructions for reviewing the claim and the medical evidence

If the Disability Appeals Council finds that disability benefits should be denied, the claimant may file a federal appeal. However, this is an extremely complex process that should only be undertaken with the representation of a disability lawyer experienced at handling federal appeals.

Continuing Disability Review

When you receive approval of your disability benefits claim, you will begin receiving monthly benefits checks, and you will receive back payments for any benefits to which you were entitled pending the resolution of your claim. However, disability benefits approval is not the end of the story.

All SSD recipients are subject to periodic reviews of their medical condition to ensure that they still qualify for benefits. The date for a Continuing Disability Review is determined by the recipient's expected medical improvement:

  • Medical Improvement Expected (MIE) - A CDR is typically scheduled within 6-18 months Medical Improvement Possible (MIP) -A CDR is typically scheduled once every three years
  • Medical Improvement Not Expected (MINE) - A CDR is typically scheduled every seven years or more

Most people receiving Social Security Disability benefits are classified as MIP, meaning that, in general, they can expect a review of their disability every three years. Prior to the CDR, the SSA will send you a form to complete. This may be either a "short form" or a "long form," which may be as complex and involved as the initial application form. If you had an attorney handle your initial claim, he or she will be familiar with the case and can easily help you submit the forms for the CDR.

The Continuing Disability Review is used to determine whether or not your condition has improved. If your condition is not improved, you will continue to receive benefits. If the CDR determines that your condition has improved--whether through evidence of gainful employment, physician's statements indicating improvement, or lack of medical documentation to demonstrate continued disability, you will lose your disability benefits.

Oklahoma Disability Lawyer

If a disabling injury, illness, or medical condition prevents you from working, it is important to file a Social Security claim as quickly as possible. The entire process often takes a year or more, and the sooner you start, the sooner you can obtain the benefits you need to support yourself and your family. The disability application process can be exceedingly complex. Hiring a lawyer is the best way to maximize your chances of benefits approval.

If you think you cannot afford a lawyer, it is important that you realize disability lawyers do not get paid unless you win your claim. They work on a contingency basis, and any attorney fees - which are capped by law - are collected from your back payment.

Ultimately, just over 50 percent of disability applications are rejected. Improve your chances of approval by retaining a lawyer with the experience necessary to successfully handle your claim. Call the Law Firm of Oklahoma at (405) 608-4990 for a free consultation about your Social Security Disability claim.

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