The Social Security Disability Benefits Application Process

Have you already been denied your Social Security Disability Benefits? You're not alone. It is common to be denied one or more times. Don't give up! At Zivic Solutions, Ltd., we have a dedicated staff to help you through the process. Call us if you need help.

There are multiple levels in the Social Security Administration's (SSA) review and award system for disability. There is an additional level that takes you to Federal Court.

Level One, Application.

Complete the initial Social Security Disability application and in most instances, a detailed Activities of Daily Living Questionnaire. There is an extensive amount of paperwork to complete at this initial level. According to the SSA, it is necessary for a doctor to verify information in the application with pertinent medical information and confirm that the disabling condition will last 12 months or longer. Accuracy from the start is helpful.

The Disability Determination Services (DDS) in your state makes the initial disability determination. They secure medical evidence and arrange for one or more consultative exams if there is not enough evidence to make a decision. DDS employees gather and evaluate all the information to arrive at a disability determination. The wait period at level one may take as little as 3 months, but the average is 4 to 6 months. It is always good to help by submitting medical records of your problems.

Level Two, Reconsideration.

If the initial disabilty application is denied, you have 60 days to ask for a reconsideration. Your medical and vocational information will need to be reviewed and updated. At this level, a different individual within the Social Security Administration reviews the application. The SSA will send you a letter explaining how it made its decision. The average wait period at level two is three to five months.

Level Two does not exist in Alabama, Alaska, Colorado, Louisiana, Michigan, Missouri, New Hampshire, New York, Pennsylvania and two offices (LA N 00057 and LA W 00056) in California.

Level Three, Hearing.

If the reconsideration is denied, you must again notify the SSA within 60 days that you will appeal the decision, which moves the application to the hearing level. This level takes you from the SSA claims processors and into the hands of an Administrative Law Judge (ALJ). The ALJ will make an independent decision based on the evidence (including all testimony at the hearing). About 20 days prior to your hearing, you will receive a notice indicating the date, time and place of your hearing. Unless you have a good reason, you must be at the hearing or your case can be dismissed.

It is important that you submit any additional evidence you want considered to the ALJ as soon as possible. At your hearing, the ALJ will explain the issues in your case and may question you and any witnesses. The ALJ may ask other witnesses, such as a doctor or vocational expert, to provide information at the hearing. You and your witnesses answer questions under oath. You and your SSDI representative, if you have one, may question any witnesses and submit evidence. After the hearing, the ALJ issues a written decision after reviewing all of the evidence. In some cases, your representative may ask for a decision on the record, which means the ALJ reviews your claim and makes a decision without a hearing. The ALJ will send you and your representative a copy of the decision.

Level Four, Appeals Council.

If the hearing ends in a denial, you have 60 days to ask for a review by the Appeals Council. At this level, the Appeals Council will review the disability hearing decision to determine if it was rendered properly according to the law. Only evidence not previously submitted pertaining to the time period up to the hearing can be submitted.

Level Five, Federal Court.

There is also an additional appeal available. The rules at this level are specific and we encourage you to have an attorney assist you.

Award.

If your claim is awarded, the general guidelines regarding when to expect payment, including retroactive payments (if applicable), are 2 to 4 weeks for claims awarded at levels 1 and 2, and 1 to 3 months for claims awarded at levels 3 and 4.

How much you receive is determined by a complicated formula using the amount of your past earnings that have been subjected to FICA taxes. The average monthly benefit for an individual was $1,004 in 2007. The maximum monthly benefit for an individual is currently about $2,000. The maximum that a family can receive is currently about $3,400 a month.

Continuing Disability Review.

Your eligibility for SSDI benefits is subject to review at certain intervals after benefits are first awarded. These intervals are based on if your condition is expected to improve. These reviews are usually at 1, 3, 5 or 7 years. We encourage you to keep an ongoing record of your medical treatment.

For help during any level of the Social Security Disability application process, call Zivic Solutions, Ltd. at 800-400-HELP (800-400-4357)