You can apply for Social Security disability benefits at any Social Security office. You can also apply by telephone by calling 1-800-772-1213. When applying, be prepared to give the Social Security agent the names, addresses and telephone numbers of all the doctors, hospitals or clinics you have treated with for your condition. You will also need a list of all prescription medications you are currently taking or have taken for your condition, and the names of the doctors prescribing these drugs. In addition, you will need to give the names and addresses of all previous employers for the past 15 years.
Do not delay in filing your claim if some or all of this information is not immediately available. You can always contact Social Security once your claim has been filed with any necessary updates. The important thing is to file your claim as soon as you become disabled or unable to work.
It is best to start your application as soon as possible! By delaying your application you may be foregoing your right to benefits you are legally entitled to. For many persons who are already having difficulties with daily life as a result of their disability, having to fill out forms and answer questions can be very stressful. If you would like our office to begin the application process, we would be happy to assist you. Call 714-871-6440 or Toll Free at 1-866-972-1515 for a free evaluation or you can complete our form so that we may evaluate your claim.
Initial Determination
After filing your application with Social Security, your claim will be evaluated by a state agency hired by Social Security. The state agency examiners will order copies of your medical records and sometimes send you to a doctor for an examination at their expense. An initial decision is then made by the state agency based on Social Security guidelines. In 60% of all cases the claimant’s application is denied at this initial level. If the claimant wishes to appeal this decision, he or she has only 60 days to notify the Social Security office that they wish to appeal.
Reconsideration
If denied at the initial level, you can request that your claim be reviewed. This is the first step in appealing your case and is called Reconsideration. The state agency that made your initial determination will re-evaluate your case and update the medical evidence in your file. 85% of all claims that are evaluated at this stage are denied. Following this second denial a claimant has 60 days to request a hearing before an administrative law judge.
Hearing
The administrative hearing is the claimant’s best chance to get a fair decision. At the hearing, the claimant is allowed to introduce new evidence in support of his or her claim, raise objections to evidence contained in the file, offer testimony, make legal arguments and cross-examine expert witnesses. It is for these reasons that an attorney is very important at this step of the process.
Due to administrative delays and case backlogs, it can take more than ten months from the date you request a hearing before your case is actually heard. It is important that you keep treating with your doctors during this period. Likewise, it is important that you keep in contact with your attorney and apprise him or her of any changes in your medical condition. In the months leading up to your hearing, you should continue sending updated medical records to Social Security with instructions that it be included in your file. If you have retained an attorney, it is important that you stay in contact with him or her and advise them of any changes in your medical condition or any medical treatment you received. It is important that your medical record be continuously updated as you await your hearing. Unfortunately, Social Security will not undertake such a task, so it is important that you provide these records to them or hire an attorney who has the staff and resources available to contact your doctors, hospitals and clinics on your behalf and obtain copies of these records.
Your hearing will last approximately 45-60 minutes. It is an informal proceeding and generally the only people in the hearing room will be the administrative law judge, his clerk, you, your attorney, and a medical expert and a vocational expert. You are allowed to bring your spouse and any witnesses you may have. The hearing begins with the judge swearing you in and explaining the process to you in general terms. (If you are represented at the hearing, the judge will then allow your attorney to make a brief opening argument.) The judge will then spend 10-20 minutes asking you about your impairments, what you typically do on an average day, why you can’t work, and the types of things you do around the house. The judge will then ask the medical expert and vocational expert whether they have any questions for you. The judge will then proceed to elicit testimony from these expert witnesses. Most of what the experts testify to will be based not on what you have stated in your testimony, but rather on the evidence contained in your file. After the judge has questioned the experts, he or she will allow you (or your attorney, if you have one) to cross-examine the experts. The judge will then allow you (or your attorney) to offer any closing arguments.
Within 1-3 months after the hearing the judge will mail you a copy of his decision. Approximately 55% of all claims that are brought to a hearing are approved. Statistics show that people who are represented by an attorney have been much more successful in attaining benefits than people who chose to represent themselves.
If you are denied at the hearing level there is another appeal available, through Social Security’s Appeals Council. If you are denied at the hearing level and wish to appeal your case to the Appeals Council, you have 60 days from the date you received the administrative law judge’s decision to file.
Appeals Council Review
The Appeals Council will review the administrative law judge’s decision and the evidence in your file. The Appeals Council does not hold a new hearing, but rather reviews the evidence to ensure that that the administrative law judge did not err in applying the regulations to the facts in your case. You can submit written arguments to the Appeals Council stating why the administrative law judge’s decision was in err. After the Appeals Council reviews your case, it will notify you of its decision. The Appeals Council may uphold the administrative law judges decision, reverse the administrative law judge’s decision and find that you are disabled, or send your case back to the administrative law judge for a new hearing. Approximately 80% of all claims brought to the Appeals Council are denied.
Due to administrative delays, it can take from 18-36 months for your claim to be reviewed by the Appeals Council. If you receive an unfavorable decision from the Appeals Council, you can request that the Federal Court review your case.
Federal Court Review
Within 60 days after receiving a denial from the Appeals Council, a formal lawsuit can be filed with the United States District Court, seeking review of Social Security’s final decision. Although you are permitted to represent yourself at this level, the technical and legal requirements of filing a District Court claim may call for the expertise of a trained attorney.
Progression of Cases Through the Disability Process
This chart is designed to give you an idea about the progression of applications through the Social Security Administration's disability determination process and statistics on the percentage of cases denied and approved at each administrative level. It is not based on data gathered by tracking individual cases through the process - rather it is based on aggregate data for all appeals in FY 2001 for Title II (Disability Insurance), Title XVI (Supplemental Security Income) and concurrent applications. Experience can vary from year to year and by application type. Additionally the numbers presented are rounded up.
Note that 60% of disability applications are denied at the first level of the process, and of these disapproved claims only 25% of all claimants file an appeal. At the reconsideration level, almost 85% of all claims are denied. Of these claims, 19% are appealed to an administrative hearing. Approximately 60% of all claims brought to the administrative hearing level are a successful.
Note: This chart is for illustration purposes only and is based on assumptions that may or may not be applicable in any given case. In addition, the chart does not reflect recent decisions made by the Commissioner of Social Security to improve the administrative process. Therefore, the chart should not be relied upon by a claimant to determine whether to pursue his or her own claim.