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.

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.

What Benefits Are Available for Disabled Persons Through the Social Security Administration?

For individuals who are disabled and unable to work, there are two types of benefits that might be available through the Social Security Administration. For both of these benefits, however, it is necessary to prove that you qualify as a disabled individual under the Social Security rules and regulations.

Qualifying for these benefits involves an analysis which takes into consideration the actual impairments, as well as someone’s age, education, and past work experience. It is not simply a question of having a diagnosis, but rather how severe that impairment is and how it affects an individual’s ability to perform basic work activities.

To receive any disability benefits through the Social Security Administration, it is required that the individual have a life-threatening impairment or an impairment which is expected to last for at least twelve months and which effectively renders that person incapable of performing any competitive full-time employment.

Social Security Disability Insurance Benefits

If an individual has worked and paid into the Social Security Administration for at least ten years in their lifetime, and for at least five out of the last ten years, he or she is potentially eligible for Social Security Disability Insurance benefits. Social Security Disability Insurance benefits are essentially an individual’s retirement benefits that he or she may be able to receive early, before reaching retirement age, because the individual is now incapable of working.

If someone has not worked and paid into SS for more than five years, that individual still might qualify for benefits if it is possible to establish that they became disabled prior to what is known as a “date last insured,” or DLI. If someone becomes disabled after their DLI, they would not qualify for Social Security Disability Insurance benefits.

Supplemental Security Income

Alternatively, individuals who have not worked and paid enough into the Social Security system recently enough might qualify for what is called Supplemental Security Income, or SSI. SSI also requires that an individual establish that they are disabled and incapable of working under the Social Security rules and regulations. And again, not only is their disability an issue, but so is that person’s age, education, and work experience.

With SSI, there is no date last insured issue; however, there are earnings and asset issues which will be considered before anyone might qualify for SSI benefits. For example, if an individual has more than $2,000 in the bank or owns more than one vehicle or a rental property, they will not qualify for SSI. If an individual is married and has more than $3,000 in the bank or in liquid assets, or if their spouse makes too much money, they will similarly not qualify for SSI.

Thus, to qualify for Supplemental Security Income, you must not only be disabled, but it is also necessary that you qualify financially—regarding both assets and earnings—before you would be eligible to receive any SSI benefits.

Increasing Your Chances of Success

Regardless of the benefit type that you are attempting to obtain, it will be necessary to have substantial medical documentation of your impairments from doctors, clinics, therapists, hospitals, etc., in order to establish the severity of your disability and your limitations. The younger an individual is, generally speaking, the more medical evidence is required in order to establish a disabling impairment.

To see if you might qualify for either Social Security Disability Insurance or SSI, you should contact an experienced Social Security attorney. Only by talking to an experienced Social Security attorney can you be assured of the best possible chance of success on your disability claim, whether you are claiming Social Security Disability Insurance benefits or SSI.

The Reasons You Were Denied Social Security Benefits

Social Security benefits are an important way for our society to give and receive help when people face tragedy or are in need. However, it can be frustrating if you’re denied Social Security benefits when you believe you are entitled to receive them.

Luckily, in many circumstances when you’re denied, there is still something you can do. In this post, we’ll look at some of the possible reasons that you were denied Social Security benefits and what you can do about it:

You Earn Too Much Income

Social Security benefits are not available to everyone. Their purpose is to provide for the material needs of individuals and families, and one of the main ways eligibility is determined is by looking at the amount of money you earn.

If you earn too much income to qualify, then you will be denied Social Security benefits. Those who earn less are more likely to be prioritized for Social Security benefits because of their financial need.

Your Disability Isn’t Severe or Prolonged Enough

One of the more controversial reasons why you might be denied Social Security benefits is that your disability doesn’t qualify you for aid. If the SSA feels that your disability is not severe enough, or that you have not been affected by it for a long enough period of time, they may decide you are not entitled to benefits.

In order to qualify for SSDI benefits according to their regulations, your disability must be severe enough to last at least twelve months; if not, you could be denied benefits.

The SSA Can’t Reach You

Sometimes, getting denied is more a matter of administrative snags than anything else. For example, if the SSA is unable to reach you because you’ve moved or your contact information is otherwise out of date, you might not receive the benefits you’re entitled to. You should make sure that you are easily reachable and that your contact information remains updated if you’re trying to claim benefits.

You Haven’t Supplied the Necessary Medical Documents

You’ll need to prove you have a disability in order to claim benefits. If you fail to provide proof by not issuing the proper medical documents when you are asked to, the SSA cannot issue benefits in your behalf. Keep all your documents organized and handy so that you can produce them as and when necessary.

Your Disability Is Related to an Addiction

If your disability is related to a drug or alcohol addiction, that may be enough for the SSA to deny your claim. A person using these substances isn’t automatically disqualified from receiving benefits, but if the SSA feels alcoholism or drug use is a major contributing factor in your disability, they can deny benefits. It is unfortunately quite common for this to happen, but if you can prove that you would still be disabled even if you stopped using substances, there is no basis to deny your claim.

You Have a Criminal Record

In some cases, a criminal record will disqualify you from receiving Social Security benefits. If you were convicted of a felony and are currently imprisoned, were injured while in prison, or were injured while committing a felony, you will not be eligible to receive SSDI benefits.

You Refuse to Follow Prescribed Treatment

If your doctor or physician has given you a specific treatment or therapy to follow to help your disability improve but you are not following it, that is usually enough to be denied benefits relating to that disability. You need to make sure that you are following all prescribed therapy and treatment in order to receive benefits.

If Your Claim for Social Security Benefits Is Denied

A Social Security lawyer is a great resource for those filing for SSDI benefits as he or she can help you navigate your qualifications and how to correctly file a claim and submit medical records to the SSA. In the event that the SSA has wrongfully rejected your claim for Social Security benefits, a Social Security attorney can help you get the compensation you deserve.

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

Navigate

Latest News

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

What Benefits Are Available for Disabled Persons Through the Social Security Administration?

The Reasons You Were Denied Social Security Benefits

Our Offices

Riverside

Victorville

San Bernardino