If you are thinking about filing for disability, it is important to understand how the process works. It is not simply one application and a response. There are several levels to the process and most people have to go through more than one before they receive a final decision on whether they qualify for disability benefits.
1. Initial Application
This is where your case starts. After your application has been filed and checked for non-medical requirements like work history at the field office, your case is sent to state-run Disability Determination Services (DDS), which will obtain information about:
- Your medical conditions
- Your doctors and treatment
- Your daily activities
The DDS office will review your records and issue a decision about your qualification.
Important: Most initial applications are denied. This is very common and does not mean that you aren’t disabled and it doesn’t mean that you will never receive disability benefits.
2. Reconsideration (First Appeal)
If you are denied at the initial level, you have 60 days to file an appeal. This is called reconsideration. Your case is reviewed again by different people at the same DDS office where the disability decision was made at the initial level.
Important: Most people are denied again here. This is another normal part of the process.
3. Hearing Before a Judge
If you are denied again at reconsideration, you have 60 days to request a hearing with an Administrative Law Judge. This is an informal, non-adversarial hearing that you can attend in person, by video, or by phone. This is where many cases are finally approved. At the hearing:
- The judge will ask you questions.
- There may be experts who testify.
- You have an opportunity to explain your situation.
This is your best chance to be approved.
4. Appeals Council
If the judge denies your case, you have another 60 days to request a review from the Appeals Council. They will not be holding a new hearing. Instead, the Appeals Council looks at the judge’s decision to see if a mistake was made and they will also weigh any additional evidence submitted. They will accept written arguments that identify any legal errors in the judge’s decision, and medical evidence that predates the judge’s decision. However, the Appeals Council will not consider new medical evidence that is dated after the judge’s denial.
The Appeals Council can:
- Approve your case
- Send it back for another hearing
- Or, deny the review
Very few cases are approved at this stage.
5. Federal Court
If you disagree with the Appeals Council’s decision or denial to review your case, you have one final step available to you. You have 60 days to file a case in federal court. A federal judge reviews Social Security’s procedures and actions to ensure that they followed the law. The court can:
- Send the case back to Social Security with an order to hold a new hearing and issue a new decision
- Direct the agency to award benefits
- Or, dismiss the case
This is an unusual, complicated option, with very few cases going this far.
The Bottom Line
The disability process takes time and can be frustrating. Most people are denied at least once, often twice. That does not mean you should give up.
Each stage is another opportunity to prove your case. The key is understanding how the system works and making sure your case is presented the right way.
The experts at Disability Advocates understand what Social Security is looking for when deciding a case. From the very beginning, everything they do is focused on giving you the best chance of being approved as early as possible, while also laying the groundwork for success if your claim needs to be moved to the next stage.
If your claim has been denied, please talk to us before giving up. Social Security only allows 60 days to request that your case be reviewed after the initial denial, so it is important to call Disability Advocates as soon as possible!