Social Security Disability benefits can provide critical financial assistance for people that are disabled and no longer able to earn a living. Applying for these benefits, however, can be a complicated, confusing and frustrating process. Most people who apply for Social Security Disability benefits will get denied initially. As a result, people applying for Social Security Disability benefits often go through a long process before getting the benefits they need and deserve. Understanding the process and not getting discouraged by an initial rejection can mean the difference between eventually receiving Social Security Disability benefits and remaining empty handed.
In this post, I review the steps of the process that may be required to get Social Security Disability benefits. While benefits may be granted at any one of these steps, it is crucial to remember that most people will go through several steps before they win their claim for benefits.
Initial Claim
The first step to obtaining Social Security Disability benefits is the initial application. To begin the process, you must file an application. There are several ways to file an application including (1) going to a local Social Security Administration (SSA) office), (2) speaking with SSA over the phone, (3) asking an attorney to assist you with the paperwork and arrange an appointment for you.
During your initial application process, SSA will request information from you including, your social security number, date of birth, your alleged onset of disability, contact information for your treating physicians, information about your employment for the past 15 years, income and asset information, and information about your activities of daily living. Once you have completed the initial application, you may also be sent additional questionnaires pertaining to your work experience or particular impairment. The Social Security Administration may also require that you attend an appointment with a consultative examiner. The purpose of this appointment is for the examiner to determine whether the disability for which you are requesting benefits meets the appropriate guidelines of the Social Security Administration.
Some individuals are approved at this level of the claims process. Most are not. The beginning of the application process is very important for every claimant because it is crucial at this point to accurately describe your condition, your past work experience and your current level of functioning. Once you have responded to these questionnaires it is often very difficult to change your answers. Often times, applicants are denied benefits at this stage because they complete the required paperwork incorrectly or do not provide enough detail.
Reconsideration
Most people applying for Social Security Disability benefits are denied at the initial claim stage. If you are denied, you should immediately file a Request for Reconsideration. This is the next step in the process for obtaining Social Security Disability benefits. With the Request for Reconsideration, you will also be required to complete a Disability Report - Appeal. In this paperwork, you will be asked about any additional or worsening impairments or the contact information for any additional physicians they may be seeing at the time. As with the initial claim, completing the paperwork accurately is critical to move the process forward.
Unfortunately, at this stage, the Social Security Administration usually reaffirms its original decision and denies the applicant Social Security Disability benefits.
Hearing
After being denied at the Reconsideration stage, you must file a Request for Hearing. This is a request to have your claim heard before an Administrative Law Judge. During this hearing, an Administrative Law Judge (and not the Social Security Administration) will decide whether you should be awarded Social Security Disability benefits. The hearing is informal but your testimony will be taken under oath. At the hearing, the Administrative Law Judge will often have a vocational expert and/or a medical expert to testify. The vocational expert will testify as to what your past work entailed and assist the judge in determining whether based on your condition you would be able to work. The medical expert will testify and provide an opinion as to your medical condition. During the hearing, you will be asked to testify regarding your age, education, past work experience, and functional limitations.
At this point it is very helpful for claimants to have an attorney present. An attorney should work to ensure that all the evidence is properly entered into the record, you understand the types of questions that you will need to respond to, and the proper questions and answers are asked of the experts at the hearing. Having an attorney greatly increases your chances of winning at the hearing level and also helps preserve the record in case you are required to appeal the Administrative Law Judge’s decision.
Appeal to the Appeals Council
If you are not granted benefits after a hearing before an Administrative Law Judge, there are still several steps of appeal available. The first level of appeal is to the Appeals Council. At this stage, the Appeals Council will request formal legal arguments explaining why your claim for Social Security Disability benefits is justified and why the Administrative Law Judge was wrong to deny benefits in the first place. As you can imagine, at this stage of the process, a legal background is vital to successfully argue for benefits. After reviewing the legal arguments submitted, the Appeals Council can then do one of three things:
1) Agree with the Administrative Law Judge’s decision
2) Send the case back to the Administrative Law Judge to evaluate it once again
3) Disagree with the Administrative Law Judge and grant Social Security Disability benefits to the applicant
Federal Court
If the Appeals Council decides to agree with the Administrative Law Judge’s decision (and, yet again, deny benefits), you can further appeal your claim to the Federal Court. At this stage, an attorney is crucial because the judge will request legal briefing on the matters you are appealing. Without an attorney, a claimant has little chance of success at the federal court level. Like the Appeals Council, the Federal Court can rule in one of three ways:
1) Agree with the Administrative Law Judge’s decision
2) Send the case back to the Administrative Law Judge for further consideration
3) Grant Social Security Disability benefits to the claimant.
Take Home Message
Applying for Social Security Disability benefits is often a long and complicated process. While most applicants will initially be rejected, many steps are available to appeal the initial decision and still receive benefits. The further in the process you go, the more complicated the steps become and the more necessary it is to have some legal knowledge and experience. It is crucial to make the most of every step of the process through an effective and persuasive application and argument for benefits.
This is NOT legal advice. This blog provides general information about Social Security Disability cases. To discuss your particular circumstances and claim, please contact a lawyer in your area.
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