The application process for Social Security Disability Insurance (SSDI) benefits can take a great deal of time before benefits are awarded. There are things you can do however to prevent any unnecessary delays.
SSDI has three different local application stages. Benefits may be awarded at any stage in the application process, but the overwhelming majority of favorable awards are granted after the third stage, thereby requiring applicants to endure the longest wait for benefits.
The first step is the initial application. This application can be made online or hand written. A hardcopy of the application can be obtained at your local Social Security office. The application requests information regarding your condition(s), how it affects your ability to work and your daily life, your past work experience and your doctors and medications. After the application has been submitted, Social Security conducts an interview. This interview can be done over the phone or in person and requests additional information such as your marital history and financial information. It is not necessary to have an attorney at this stage.
After the initial application is submitted, Social Security reviews your eligibility for Supplemental Security Income (SSI) and SSDI. The Administration requests your medical records and reviews your application to determine if you are medically disabled as defined by the Administration. This review generally takes 60-90 days. Once a decision has been reached, a written determination will be sent to you by mail. If you are denied benefits, you will have 60 days to appeal that decision in writing to your local office.
If your initial application is denied, the second stage is Reconsideration. At the Reconsideration level, paperwork is submitted essentially requesting that Social Security take another look at your file and consider your conditions and allegations about your limitations. Sometimes these appeals are based on new medical information or that SSA did not have all the information; other times, it is because you disagree with their decision that you should be able to find some kind of work. At this stage it is suggested you hire an attorney to assist you.
The Reconsideration review takes another 60-90 days. During this time, updated medical records are requested, your file is sent for review at the Disability Determination Bureau and you may be requested to see an Independent Medical Examiner. This is often conducted when medical records are not provided or they are out of date or inconsistent. If you receive notice that you are scheduled for an Independent Medical Exam (IME), it is very important that you attend the scheduled appointment. There is no cost to you for this review, Social Security pays for the IME. It is suggested that you bring a person with you to the IME who is familiar with your conditions and limitations. This can be a family member, friend or representative.
If you are denied benefits at the reconsideration level, you have another 60 days to appeal for your case to be heard by an Administrative Law Judge. It is at this third stage, before the ALJ, where an attorney is highly recommended.
Between the time a Request for a Hearing before an Administrative Law Judge is filed and the actual hearing, there is not much more to be done than wait. This is the most difficult part for an applicant. As a result of being disabled, there generally is no income and applicants are living off their savings. In the Milwaukee area, it can take up to 22 months to receive a hearing because of the volume of cases being heard.
During the interim months, it is important to keep your attorney updated with changes in your condition(s) and living and financial situations. This is important because new information may provide an opportunity for intermediary action. While a hearing request is pending, there is little your attorney can do to speed up the process. There are however two opportunities to resolve the matter without a hearing.
The first is “dire need”. Dire need occurs when an applicant is being evicted or their home foreclosed on. Dire need can also occur when a person has exhausted all financial resources. By informing your attorney if this type of situation occurs, you may be able to have a dire need request filed and have your case called earlier. Please be aware that Social Security does not view dire need lightly and the circumstances usually must be grave.
The second opportunity to have your case resolved without a hearing is to submit an on the record request. This letter, from your attorney, essentially breaks down your case for a Staff Attorney, discussing your condition(s), limitations, restrictions and ability to work in a way that outlines why you should be considered disabled in accordance with SSA’s guidelines. If a decision cannot be made on the record, your case will still be scheduled for hearing, so there is no loss of rights if an on the record request is denied.
Even after a favorable award, benefits are not immediate. There are different variables that affect how long before a payment is made, but the general minimum is three months. If, after three months, you still have not received any payment, your attorney can help you receive funds from your local office.
Overall, the amount of time from initial application to benefits receipt can take years, however working with an attorney and being prompt about filing appeals can shorten that time.