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Social Security Disability Case Stages

We've mentioned on our Facebook page before just how long and overwhelming the disability process can be from start to finish. But, rather than continuing to reiterate that fact, we thought we'd give you a detailed breakdown of the different stages, and an approximation of time that it might take for each one.

The first stage is the Initial Application. Every individual applying for disability must complete an initial application. There is a great deal of paperwork required in this stage. And, much like we've mentioned before, the Social Security Administration indicates that it's necessary to have a doctor verify that the individual applying has a disabling condition that will last for at least 12 months, if not longer. The decision is made by the Disability Determination Services and can take as little as three months to receive. The average wait time, however, ranges from four to six months-and less than 40 percent of all applications are approved at this stage.

The second stage is Reconsideration. For the individuals whose claims were denied at the initial application stage, there is a 60-day deadline to appeal the decision. Once a decision has been appealed, the review of an individual's claim begins all over again. This review can take an additional three to five months before a decision is issued. When a decision has been reached, the individual applying for disability will receive a detailed letter explaining how the Social Security Administration came to their decision. At this stage, less than 20 percent of claims are approved.

The third stage is Hearing. If an individual's claim is denied at the reconsideration level, there is another 60-day window to appeal the decision. This stage moves a claim from the claims processors at The Social Security Administration and on to an Administrative Law Judge (ALJ). At this stage, much like the others, it is incredibly important to ensure that all medical evidence pertaining to an individual's claim has been submitted to the SSA. It is the medical evidence, in addition to an individual's testimony, that an ALJ will use to render a decision. While this stage is accompanied by the longest wait time (an average of 426 days, or14-months), it is also accompanied by the highest award rate. Over 60 percent of applicants are awarded their benefits at this stage.

The fourth stage is Appeals Council. Although the hearing stage boasts the highest numbers in regards to approved claims, not every claim will be victorious. For the claims that receive an unfavorable outcome, there is another 60-day window to appeal the decision. At this stage, the Appeals Council will review the ALJ's decision to determine if it was rendered in accordance with the law. The SSA indicates the wait time at this stage averages at just under a year.

Using the highest averaged amount of time per stage, some claims can take over 3 years before a final decision is rendered. Unfortunately, those are just the averages-which means, some individuals will not have to wait nearly as long...and some might have to wait even longer. The current backlog, which we've mentioned in past blog posts, has increased recent wait times. As always, we encourage out clients to reach out to their state Senators and Representatives and let them know about the things (such as their Social Security Disability claims) that so clearly affect their lives. If you're a client and have any questions or concerns about the different disability claim stages, or about contacting your state Senators and Representatives, please leave a comment and we'll be happy to provide an answer!

**All wait times are averages based upon past-year(s) figures from the Social Security Administration. More information is available HERE**

2 Comments

Hello,
I am writing in regards to my SSI claim. I am currently awaiting an answer on my claim for disability due to fibromyalgia.I am interested in contacting my Senator or Representative n my area. I reside in Marietta, Ga. Will you please help me in contacting my representative and direct me on what I need them to do?

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