Steps of an SSDI or SSI Claim

When you file for Social Security disability benefits and/or SSI, your case may have to pass through several different steps of the claims process in order to be approved. Following are the steps that make up the Social Security disability and/or SSI claims process:

1. Initial Application

The first step in submitting a claim for either Social Security disability benefits and/or SSI is to file an application with the Social Security Administration (SSA), either online or in person. The Social Security Administration generally awards payment to between 40% and 50% of initial applicants for disability benefits. Normally, the initial determination in a claim for disability benefits takes anywhere from 30 to 120 days.

2. Request for Reconsideration

If your application for disability benefits is denied by the SSA, it is then necessary to file a request for reconsideration in order to keep your case going and have any chance of eventually obtaining disability benefits. You have 60 days from the initial denial letter in which to file a request for reconsideration. Normally, a request for reconsideration takes anywhere from 30 to 120 days to get a response from the administration. Generally, the SSA denies approximately 90% of the requests for reconsideration. So if someone receives an initial denial, it is highly likely they will also receive a denial on the request for reconsideration, which makes it then necessary to file a request for hearing by an administrative law judge in order to keep their claim alive.

3. Request a Hearing with an Administrative Law Judge

A request for hearing by an administrative law judge must be filed within 60 days of receiving the request for reconsideration denial from the SSA. Presently, it is taking on average between one year and one and a half years to obtain a hearing with an administrative law judge (ALJ) after the request for hearing is filed. For most people, this is the hardest part of the claims process, due to the lengthy delay in getting a court date to have a judge listen to and decide your claim.

4. Request for Review by the Appeals Council

Once the administrative law judge makes a decision in your case, if it is favorable, you enter into pay status and will start receiving your disability benefits. If the ALJ denies your claim, it would be necessary to then file a request for review of the ALJ’s unfavorable decision with the Social Security Appeals Council in Virginia. The request for review must be filed within 60 days of the ALJ’s unfavorable decision, and it can often take over a year to receive a response from the Social Security Appeals Council at this step of the process.

5. Civil Action in US District Court

If the appeals council denies your appeal, it would then be necessary to file a civil action in the United States district court where you live in order to keep your claim ongoing and have any chance of getting benefits. Alternatively, the appeals council can decide in your favor and send the case back to the administrative law judge for a supplemental hearing, at which time the administrative law judge will hear more evidence and render a new decision in your case. However, if the appeals council once again denies your case and it is necessary to file a civil action in the US district court where you live, you must hire an attorney to assist you if you have not already done so. This is because procedures are very complicated and technical at this step of the appeals process, and they require interaction with the United States Attorney’s office and federal judges. The earlier you hire a disability attorney to assist in your claim for Social Security Disability Insurance benefits and/or SSI, the better it will be for your claim. A qualified attorney can assist in fully and properly developing the medical evidence of record in your case and giving you the best chance of success at each step of the claims process.