The process of applying for disability benefits can be long. But the longer you wait to begin, the more time you’ll ultimately add to the process. We’re ready to dig in and get busy. Here’s a brief description of the levels of the process and what you can expect at each stage.
Level 1 – Initial Application: The Fact-Gathering Stage
Usually three months for decision.
The first step in obtaining Social Security benefits is to file an application. After that, you will be given a Disability Report to complete. The form requests personal information about you and your disability such as the names of your doctors and your past employers. You should have all of this information. It is important that you be thorough on this report.
About 30 days after you apply, your file will be assigned to a Medical Adjudicator at the Office of Disability Determinations (ODD). By law, the Medical Adjudicator must order all of your medical records from each of the doctors and hospitals you listed on the Disability Report. This is why it is important to be thorough. We want them to obtain every piece of medical evidence important to your case.
At this stage, you may receive additional forms asking you to describe your pain and symptoms, or you may be asked to attend one or more medical examinations. We will advise you whether to attend these exams or not. All of these steps are important to gather the evidence we will need in your case so it is important to cooperate with the Adjudicator.
After all of the relevant information is in your file, a decision will be issued by the Adjudicator. You will receive a copy of the decision. This usually takes about three months. We only have sixty days to file an appeal if your case is denied.
If you are turned down on your initial application, don’t give up! We feel strongly about your case and we will continue fighting for you.
Level 2 – Reconsideration: Taking a Second Look
Usually three months for decision
If you are turned down on your initial application, we will file a Request for Reconsideration for you. The Reconsideration process is an opportunity for a different Adjudicator to take a look at your claim and determine whether to change the Administration’s decision. By law, the Adjudicator must order new medical evidence not listed on the initial Disability Report. Therefore, when we ask you for an update regarding your medical care, please be sure to tell us every new doctor you have seen and every new hospital you have been to since you filed your initial claim.
Again, you will receive a decision on your Reconsideration within about three months. If you are denied at this level also, please don’t despair! We have only just begun to fight!
Level 3 – Administrative Law Judge Hearing: Your Day in Court
Usually twelve to eighteen months before scheduled.
If you are denied at the Reconsideration stage, we will request a Hearing for you. On average, it takes twelve to eighteen months to obtain a hearing date. This long wait is due to the backlog of people waiting for a hearing. A high percentage of cases are won at the hearing level.
In preparation for the hearing, we may ask you to attend another medical exam to fill in some missing information for your case. We will finish gathering all new medical evidence and prepare you to testify before an Administrative Law Judge assigned to only hear Social Security Disability cases. Of course, your attorney will accompany you to the hearing and make all appropriate legal arguments. After your hearing, you should receive a decision within approximately three weeks to four months, depending on the judge. Most cases are successfully concluded at this stage.
Level 4 – Appeals Council: Reviewing the Judge’s Decision
Usually three to eighteen months for decision.
If we do not win your case with the judge, we can appeal your case to the Appeals Council. You will not need to be present for a hearing at this level. It is a written review only. We will generally appeal your case as long as we believe the weight of the evidence supported a favorable decision by the judge.
Level 5 – Federal District Court: Final Review
Usually six to eighteen months for decision.
If we are unsuccessful with the Appeals Council, we can appeal to Federal Court. We do not appeal every case to Federal Court, only the ones in which we feel the Judge erred as a matter of law. This is because the Federal Court cannot “second guess” the Administrative Law Judge’s opinion, but must determine whether the judge abused his discretion or erred as a matter of law.