How the Process Works
Step One: The Initial Application
You can apply for SSI or DIB benefits at any Social Security Administration (SSA) local office. To find out which office is closest to you, call SSA at 800-772-1213.
When you apply, you will speak with a "claims representative." This worker will ask you many questions. The representative will also want details on your medical treatment, so have that information ready.
After you apply, SSA will try to get copies of your medical records. SSA's own doctors will review your records and your complaints. It may also ask you to go to other doctors for an exam at its expense. Social Security will notify you of its decision in writing. It normally takes SSA 90 days from the date you apply to make a decision. However, if there are problems getting medical records or you get sent to see one of their doctors, it may take several more months from the date you apply to get a decision from SSA.
If you are given benefits, SSA will send you a "Notice of Award" letter saying how much you can expect. If you are denied benefits, SSA will send you a "Notice of Disapproved Claim" letter that should say why SSA denied your claim.
In some cases, a reconsideration may take place. This is only applicable to individuals whose benefits are being terminated, whose denial was based on non-medical reasons (i.e. too much income), or who live in certain states other than Missouri. A reconsideration is a repeat of the first stage, except that the claim is reviewed and decided by a different person.
From the date that you receive your denial, you have 60 days to appeal - to request a hearing before an Administrative Law Judge (ALJ). If you are going to appeal, you should do so as soon as possible. If we are already representing you, we will help you file this appeal.
Step Two: The Hearing with an Administrative Law Judge (ALJ)
When your request for a hearing has been filed, your case will be sent to the Office of Disability Adjudication and Review. Here, an ALJ will take a fresh look at your case.
ALJs are employed by the SSA. However, ALJs are independent and are not bound by SSA's previous decision. Therefore, they can take an unbiased look at your claim.
As soon as the ALJ's staff has your file ready, your hearing will be scheduled. Unfortunately right now, it is taking a year or more for a hearing to be scheduled. Notice of the hearing date will be mailed you.
At the hearing, you will answer many questions about your condition, living situation, work history, education, daily activities, and anything else that judge thinks is important. Some judges do their own questioning, and others have the lawyer, if one is present, ask questions.
Usually the only people present at the hearing are you, your lawyer, the judge, and the clerk. Sometimes the judge will ask an expert witness to testify. In some cases, you may have a witness come to testify on your behalf.
Most hearings last an hour or less. At the end of the hearing, the judge may close the record. The judge may also hold the record open to let your lawyer submit more evidence, usually medical records. Sometimes the judge will send you to a doctor for a medical exam.
Once all the evidence is in, the ALJ will decide your case. Some judges decide cases more quickly than others. There is no set time period within which a decision must be made. It could take several months after the hearing to get a decision from the ALJ.
You will get the ALJ's decision in writing. If you win, SSA will let you know, usually within a few months, how much money you will be getting. If you lose, you have 60 days to appeal to the Appeals Council. If we represent you in this appeal, we will file it for you.
Step Three: After the Hearing
The Appeals Council is in Virginia, and appeals to it are done on paper. If we represent you in an appeal, we send the appeal forms for you. We usually also send an argument explaining why we think the ALJ's decision was wrong. It can take 4-24 months or more to get a decision from the Appeals Council. If you lose at that level, your last appeal is to the Federal Courts.