How to File a Social Security Disability Claim

Effective and Aggressive representation at all levels of the Social Security Disability claims process brings results. We can help you complete forms and obtain reports from your doctors that will make a difference in your claim. We will make sure that every aspect of your case is thoroughly developed and argued to the Social Security Administration. If your claim goes to a hearing, you will know what to expect, and you will be prepared.

Application

If you believe that you may be entitled to one of the social security disability benefits listed above, you should go to your local Social Security District Office to file an application, or call 1(800) 772-1213. You will be asked to complete several different forms, some of which we may be able to help you complete.

Request for Reconsideration

When Social Security denies your application for social security disability benefits, you can file an appeal called a Request for Reconsideration. If you choose to file the Request for Reconsideration, you must do so within 60 days of the date you receive your first denial letter.

Request for Hearing with an Administrative Law Judge

When your Request for Reconsideration is denied, you have 60 days to file an appeal called a Request for Hearing with an Administrative Law Judge. This is the first opportunity for you to actually meet face to face with a person who will be deciding your claim. This is usually the best opportunity to win a claim.

Request for Review of the Judge’s Decision

If the Judge denies your social security disability claim, you have 60 days to file a Request for Review of that decision with the Appeals Council in Falls Church, VA. This appeal can take as long as 2 years.

United States District Court

If the Appeals Council denies your Request for Review, you have only 60 days to file a lawsuit against Social Security in the United States District Court.

Can I Qualify for SSDI or SSI if I Am Able to Work?

Generally, in order to be eligible for Social Security Disability Insurance Benefits (DIB) or Supplemental Security Income (SSI), Social Security requires that you prove that you have one or more impairments which prevent you from engaging in significant gainful activity for at least one year.

In other words, you have to have an impairment or impairments which keep you from working for at least one year.

Although that rule seems cut-and-dry, there are some specific variables and circumstances to consider, especially how restricted your ability to work is and whether those restrictions fall within those allowed according to your age group.

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Social Security Administrative Law Judge Hearings in the Time of COVID-19

Normally when someone applies for Social Security Disability Insurance Benefits (DIB) or Supplemental Security Income (SSI), he or she is either found disabled and entitled to benefits, or that individual has to file a number of appeals in order to eventually get approved for benefits.

After applying for benefits and being initially denied, then being denied for reconsideration, the third step of this process involves a hearing with an administrative law judge (ALJ).

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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.

Positive and Negative Factors Which Can Affect a Disability Claim

When an individual applies for Social Security disability and/or SSI benefits, there are various factors which can positively or negatively affect their claim.

Positive Factors

For example, if an individual is over 55 years of age, that is generally a positive factor, since the Social Security rules and regulations take age into consideration. It becomes easier to be approved as an individual gets closer to retirement age.

Additionally, an individual who has a strong and solid work history with minimal gaps in earnings also has an advantage, since the Social Security Administration (SSA) generally looks favorably upon individuals who have strong and consistent work histories.

Also, individuals who have significant medical documentation establishing their impairments, symptoms, and limitations are also looked upon favorably by the administration, since it is always necessary to prove a disability rather than merely tell the Social Security Administration about your problems. It is not a question of what you tell them, but rather what can be proven to the SSA with medical evidence.

Negative Factors

Alternatively, individuals who have a poor work history, or who perhaps have never worked and paid money into the Social Security Administration, are not looked upon favorably. They generally have a more difficult time obtaining disability benefits, since their connection to the workforce is questioned by the administration.

Similarly, individuals who have been incarcerated or who have a history of substance abuse, such as use of street drugs or heavy alcohol consumption, can have a more difficult time in obtaining benefits, depending on the nature of their impairments. For example, if an individual is alleging that mental impairments make them disabled, but they have engaged in substance abuse of street drugs and/or alcohol, that individual is going to have a difficult to impossible time in getting approved for Social Security disability benefits.

The younger an individual is, the more difficult it is to obtain Social Security disability and/or SSI benefits, since the Social Security rules and regulations do not give younger individuals any assistance in establishing disability. In fact, if a younger individual in their 20s, 30s or 40s is capable of showing up to work every day and being there for an eight-hour period, Social Security will, in most instances, find a job somewhere in the country which they are capable of performing, and thus deny benefits in that case.

For younger individuals, it is basically required that they establish an inability to be at a job eight hours a day, five days a week, in order to qualify for benefits.

Hiring an Attorney Will Help Your Case

It is critically important to a claim for Social Security disability and/or SSI benefits to consult with an experienced attorney who is knowledgeable about all of the various factors taken into consideration by the Social Security Administration in disability claims.

There are factors which can make or break a disability claim, regardless of the impairments being alleged. Only by hiring an experienced Social Security disability attorney can you be certain that these positive factors can be emphasized and the negative factors minimized in order to have the best chance of success on your claim.

Questions to Ask When Looking for a Social Security Attorney

Hiring a qualified and experienced Social Security attorney to assist in your claim for either Social Security Disability Insurance benefits or Supplemental Security Income is extremely important and increases the chances of success on your claim significantly. Here are a few vital questions to ask to ensure you receive the best possible representation for your claim.

Which Attorney Will Help with My Case?

When you first contact a Social Security attorney for assistance on your claim, it is important to ask which attorney will be helping you on your case and when you will first have an opportunity to meet that attorney. Many offices have resorted to randomly assigning cases to various representatives on their staff, and unfortunately, the claimants never have an opportunity to meet these representatives until the actual day of their hearing in front of an administrative law judge. This is unacceptable.

If a law office tells you that they do not know who will be assigned to your case, or that you cannot meet with your attorney until the day of the hearing, you need to look for a different attorney. It is your right to know who will be representing you in this process and how much experience they have in representing Social Security claimants such as yourself.

When Will I Meet My Attorney?

Every claimant for Social Security Disability Insurance or SSI should have multiple meetings with their representative prior to going into court with an administrative law judge. These meetings are necessary not only to develop a rapport between the representative and the client, but also to ensure that the record is fully developed by obtaining all medical information so that all of the relevant medical records can be secured prior to the hearing in the disability claim.

Additionally, multiple meetings assist with the attorney’s understanding of the nature and severity of the impairments and how they affect and limit the client. It is simply impossible to have an understanding of the nature and severity of your client’s impairments without meeting with the client in advance.

If a law office tells you that they don’t know who your representative will be should you have to go to court with an administrative law judge, you should continue to call other attorneys until you can be sure of who is actually going to work on your case. You should not wait years to have your day in court only to find out that the attorney knows nothing about your case, or you, or your impairments.

There is simply no substitute for time spent meeting and discussing your case with your attorney.

What Levels of the Claims Process will My Attorney Assist With?

Additionally, when you first contact the attorney’s office, you should ask what levels of the claims process they assist with. For example, some law offices will assist with the actual applications process, the request for reconsiderations, and/or the request for hearings, but they terminate the relationship if a case is lost at the ALJ hearing level.

Other offices represent clients for disability benefits at all steps of the appeals process through the US district court level. It is important to understand at what levels your attorney will assist you and what happens if you receive a denial at any level of the appeals process. You need to know this information prior to entering into an attorney-client relationship and agreeing to pay that attorney for his or her help.

What Is My Attorney’s Winning Percentage?

Claimants for Social Security Disability Insurance benefits and/or SSI often ask what an attorney’s winning percentage is. This is somewhat difficult to quantify, given the fact that winning percentages vary depending on the stage of the appeals process and other factors over time.

For example, most attorneys are not successful in obtaining benefits at either the “request for reconsideration” stage or the “request for review” stage of the appeals process. Attorneys typically have better success at either the hearing stage, where a decision is rendered by an administrative law judge, or perhaps in the US district court, at one of the final stages of the appeals process. Again, this is a question that should be asked of your potential representative prior to hiring that attorney to represent you in your disability claim.

Also, a winning percentage varies depending on the facts of each case. Winning percentages on clients who are younger will likely be much lower than with clients who are approaching retirement age.

Hiring an experienced Social Security attorney who will take the time to sit down and discuss your case with you on multiple occasions prior to actually going into court with you is critical to proper representation in these disability cases. It is up to you to ask the relevant questions and make the determination whether this is a representative you want to hire or not.

How to File a Social Security Disability Claim

Application

Request for Reconsideration

Request for Hearing with an Administrative Law Judge

Request for Review of the Judge’s Decision

United States District Court

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Latest News

Can I Qualify for SSDI or SSI if I Am Able to Work?

Social Security Administrative Law Judge Hearings in the Time of COVID-19

Steps of an SSDI or SSI Claim

Positive and Negative Factors Which Can Affect a Disability Claim

Questions to Ask When Looking for a Social Security Attorney

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