Justin S. Raines
What is the disability application and appeal process?
When you’re applying for Social Security disability, it’s important to understand both the legal standard for winning your case and the application and appeal process. The application and appeal process is known as the administrative review because it takes place before the Social Security Administration (SSA).
If the claimant has used up all the appeals in the administrative review, the claimant may then sue the government in a United States district court to demand an award of disability benefits. How those lawsuits work will be discussed in a future post.
If you’re disabled, why can’t you just sue the government from the start to demand that it award you disability benefits? For several reasons, the claimant must file an application for disability benefits with the SSA and exhaust every appeal with the SSA before being allowed to sue.
Social Security Disability Applications
Social Security Disability Insurance (SSD, SSDI, or DIB) applications are filed online. Supplemental Security Income (SSI) applications are filed on paper. They both take an average of three to five months to obtain a decision. Sometimes they are decided faster, and sometimes they are decided slower.
Request for Reconsideration
If a claimant’s application for disability benefits is denied, the claimant has 60 days from the date of the decision to file a request for reconsideration. These also take about three to five months to get a decision. It is important to file a request for reconsideration as soon as the application denial is received.
Request for Hearing before an Administrative Law Judge
If the request for reconsideration is denied, the claimant has another 60 days to file a request for hearing before an administrative law judge (ALJ). It is important to file a request for an ALJ hearing as soon as the request for reconsideration is denied.
An ALJ hearing is the best chance for most claimants to win. Unfortunately, it can take ten months or longer to get a hearing scheduled and several more months to get a written decision on the appeal.
Request for Review to the Appeals Council
If the ALJ hearing is denied, the claimant has another 60 days to file a request for review to the Appeals Council. To win a request for review, the claimant must show that the ALJ made a legal error or that the ALJ’s decision was not supported by a minimum amount of evidence—called substantial evidence.
If the Appeals Council denies the appeal, then the claimant has 60 days to sue the SSA in federal court.
About a third of initial applications are denied, but if you have a severe physical or mental illness or injury that keeps you from working, it is important not to give up! The SSA often makes the wrong decision, and that’s what appeals are for!
If you have a severe physical or mental illness or injury, you should consult with an attorney experienced in Social Security disability for help and advice proving your case.