What Happens with My Application?

Understanding Disability Benefits: SSDI and SSI

by Kimberly Read & Jonathan A. Abbott

You’ve contacted the Social Security Administration. You’ve completed your Disability Report Form. You’ve returned it to SSA with all of the additional requested documentation. Now what? Now your application for disability is processed. You can expect at least three stages.

1. Initial Claim – Your Application
   After you have submitted all the requested documentation, your application is forwarded to a state agency that makes disability decisions. Your claim is then reviewed by medical experts. The person who decides never meets you; the decision is based on your medical records and perhaps an exam by one of their doctors. It is important that if you are requested to take a medical exam you keep this appointment. You will not be asked to pay for it.
   
   Normally, people who get disability benefits at this step are those whose problems can be measured by medical tests. Brain (mental) illnesses, and anything vague like pain or headaches, usually can’t be measured, so people with these real problems are routinely denied benefits initially (Abbott).

2. Reconsideration – Your First Appeal
   When (if) your initial claim is denied, you will receive a notice in writing which will be labeled as a “Notice of Disapproved Claim,” a “Notice of Reconsideration” or a “Notice of Federal Reviewing Official Decision.” You will have 65 days from the date on this notice to submit your appeal. You will be required to complete the Appeal Disability Report. At this stage, your application will be reviewed by a different person. However, you will probably be denied again.

   NOTE: In some states, this step was eliminated from the process. The states where the reconsideration step was eliminated are Alabama, Alaska, California (Los Angeles North and West areas), Colorado, Louisiana, Michigan, Missouri, New Hampshire, New York (Brooklyn and Albany areas), and Pennsylvania.

3. Hearing – Your Second Appeal
   At this point, you will be given the opportunity to schedule a hearing with a judge who specializes in disability. The judge actually meets with you and talks to you about your medical problems, your work history and why you can no longer work well. Claims generally do well at this stage for several reasons:
   
   
   • At the hearing, the decision maker actually gets to meet you.
     
     
   • Most people hire a representative, a person who knows exactly what needs to be proved to win benefits. SSA statistics show higher rates of success with attorneys at every decision level. (Even at the initial and reconsideration points, people win much more frequently with attorneys than without.)
     
     
   • Successful claimants and their attorneys use the months of waiting to make sure their medical records are complete and document ALL their medical problems, not just the biggest one or two. They get other critical reports and exhibits.

Two and a half million people apply for SSDI or SSI each year. Most (almost two-thirds nationally) are denied benefits initially. However, those who stick it out through the appeal and then a hearing with a judge do well. Almost two-thirds win! (Abbott).

Understanding Disability Benefits – The Series

1. I Can’t Hold a Job! What Do I Do? – Introduction
   
2. What is Disability?
   
3. Do I Qualify for Disability?
   
4. Is Bipolar Disorder a Qualified Condition for Disability?
   
5. How Do I Start My Disability Application?
   
6. What Information and Paperwork Do I Need?
   
7. What Happens with My Application?
   
8. How Long Will It Take to Get Benefits?
   
9. What Benefits Will I Get?
   
10. Who Can Help Me?