Disability Approval Timeline
The Social Security Disability and SSI application process is a lengthy one and consists of three main levels: Initial, Reconsideration*, and Hearing. There are also appeals after the hearing level, but they are less common and less effective than the three main levels.
When a claimant first applies for Social Security Disability Insurance Benefits (DIB) or Supplemental Security Income (SSI), it is called the Initial level. It generally takes about 4-6 months to receive an approval decision. During this time the file is processed at the District Office (DO) and then sent to the Disability Determination Services (DDS). The Disability Examiner will then request medical records and collect evidence. If there is a lack of evidence or clarification is needed, a Consultative Exam (CE) may be scheduled.
When the file is complete, or all medical evidence has been processed, a Medical Examiner will make a decision. The decision is sent to the claimant (and the representative, if applicable) and the file is sent back to the District Office. It is estimated that about 60-75% of claimants are denied at the Initial level… (continued after infographic)
The next step is to appeal for Reconsideration. Once the Reconsideration appeal has been filed, the file is again sent to DDS for a decision. The file is reviewed to determine if anything was overlooked and gather any new or additional evidence. Then a different Medical Examiner makes a decision. This step in the process takes approximately 3-5 months. The estimated denial rate at this level is 75-80%.
Next is the Hearing level. Once the Request for Hearing has been filed, the file is sent to the local Hearing office, or Office of Adjudication and Review (ODAR). A hearing is then scheduled and the claimant appears before an Administrative Law Judge, who makes a decision based on medical records and testimonies from the claimant and expert witnesses. The decision is then sent to the claimant and the representative (if applicable), and the file is sent back to the District Office. This whole process takes 12-18 months (longer in some states), but has the highest success rate. About 1/3 of claimants who appear unrepresented are approved, while about 2/3 of claimants who are represented are approved.
If a claimant is denied at the Hearing level, the next appeal is to the Social Security Disability Appeals Council, and finally to the Federal District Court. Your legal representative has more information about each level of the process.
*The Reconsideration level has been removed in some states. For information on your next appeal, check the appeal paperwork or ask your disability representative.
Author – Brad Myler