Steps to Expect in the Social Security Disability Insurance Process
Going through the Social Security Administration's (SSA) review and award system for disability could take from six months to three or more years.
There are five overall steps or "levels" of the Social Security Disability Insurance (SSDI) process:
Each one can be fraught with complications and issues that can be extremely difficult for an individual attempting the process alone. From initial application through Federal Court (only a small percentage of the cases actually end up in Federal Court), you will be required to fill out detailed government forms, submit doctor records, complete questionnaires, and much more. The right representation at the very beginning can help you receive your benefits in less time and with less stress.
Level One: Application – Six Months (Average Wait)
The initial application is the most critical step for a quick approval of benefits. Many attorneys or disability service companies tell clients to "go and apply and once you’re denied, come back and see us." That approach is not in your best interest. Even though the SSA denies 65% or more of initial applications, the right representation and assistance can provide a greater than 75% chance of initial approval at this stage.
Paperwork in this stage can be daunting, and might include all of the following and more:
- Social Security Disability application
- Activities of Daily Living questionnaire
- Doctor or medical records to verify information in the application and confirm that the disabling condition will last 12 months or longer
- Possible consultative exams with other Doctors to verify or produce consistent evidence
These represent just a few of the forms that must be filled out correctly in order to get the best chance of approval. An experienced representative who knows the process and form requirements can save an individual a great deal of time and anguish.
Remember, with advocacy, you have a much better chance of never having to proceed beyond Level One. Contact Us
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Level Two: Reconsideration of Your Case or First Appeal – Six Months (Average Wait)
Not everyone will face this step. However, if your first disability application is denied, you have 60 days to ask for a reconsideration or first appeal. Your application is then sent to the next reviewer at Social Security. During this time, your medical and work information will need to be reviewed and updated. Typically, a decision will be made on your case in about five months once the appeal has been submitted.
It is important to set your expectations carefully should you encounter Level 2. According to SSA’s own numbers, only about 10% of first appeals get approved. Once again, the right assistance at this level greatly increases your chances of a win.
(Alabama, Alaska, Colorado, Louisiana, Michigan, Missouri, New Hampshire, New York, Pennsylvania, and some locations in California do not have a reconsideration stage; if you are denied in level one in these states, you will proceed to the hearing stage.)
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Level Three: Hearing in Front of an Administrative Law Judge (ALJ) – Fourteen Months (Average Wait)
If you are denied at level two (or live in the one of states listed above), you have another 60 days to appeal the decision (called "second appeal" in most states) The Social Security Administration turns your case over to an administrative law judge (ALJ) who will make an independent decision based on the evidence. You will be notified of the time and place of the hearing (usually within 75 miles of your home) and you should do everything you can to attend. You will have an opportunity to submit additional evidence prior to the hearing and you have the right to have witnesses such as doctors or experts speak on your behalf.
To see how long your wait may be, try our easy-to-use Hearing Times by State Finder
As with every stage of this process, good representation increases your chances of success. Professional advocates like the ones here at SSDC are experts in achieving a favorable outcome prior to attending an actual hearing, which is called an "on the record" decision and avoids the court hearing. This level has a higher success rate than the previous two. Since the decision is being made by an official of the court and witnesses can be questioned, approximately 60% of the cases that go to this level get approved. While that is better for you, the down side is this level usually takes over 500 days to complete.
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Level Four: Appeals Council – Sixteen Months (Average Wait)
If you are again denied at level three, you have another 60 days to appeal the decision. The courts will then review the reasons for denial at level three to see if the denial was valid. The decision will then either be overturned, sent back to the ALJ for another hearing, or the denial will stand. Very few cases, less than 5%, ever get the level three decision reversed.
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Level Five: Federal Court Appeal -- Two to Three Years (Average Wait)
If your case has reached this stage, it has raised serious concerns with the Social Security Administration. Only about 1 - 2% of all cases reach this level; of these, only about 30% are approved. A portion of the reviewed cases are sent back down to the hearing level (3) to begin the process over again. You must have legal representation at the Federal Court level.
This process can be long and difficult for someone who can no longer work because of a disability. It is very important to choose a skilled representative BEFORE you even apply to increase your chances of a quick and favorable decision.
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For over 30 years SSDC has prided itself on assisting clients from the very beginning of the process. We are one of the leading advocacy organizations and have one of the nation’s highest initial approval rates at over 75%.