Written by:
Linda Cosme – Vice President of Disability Policy & Strategy, Citizens Disability
SSDI Approval Process
Applying for Social Security Disability Insurance benefits, or SSDI, can be a complex and lengthy process. Most applicants wait months—or even years—for approval, and denials are common for even the most compelling claims. Understanding the steps involved in the claims process, common delays, and ways to strengthen your claim can improve your chances of success during the SSDI approval process.
Overview of the SSDI Approval Process
Social Security Disability Insurance is a federal program that pays monthly benefits to people who cannot work because of a disabling medical conditions. The Social Security Administration, or SSA, evaluates SSDI claims using a multi-step process.
To qualify for benefits, you must meet the SSA’s eligibility criteria, provide strong medical evidence of your condition, and have a sufficient work history during which you paid into the system with payroll taxes.
You must submit an initial application with supporting documentation to initiate a claim. Working with an experienced SSDI attorney or disability advocate can help you strengthen your claim. A professional with experience handling SSDI applications can help you avoid the pitfalls and submit the strongest claim possible, giving you the best shot at approval.
Step-by-Step Guide to Getting Your SSDI Claim Approved
The SSDI claims process has several levels: the initial application, reconsideration, hearing before an Administrative Law Judge, Appeals Council review, and a federal lawsuit in the United States District Court.
Step 1: Preparing Your Application
Thoroughly preparing your initial application is one of the most crucial aspects of the SSDI application process. Follow the instructions for initial applications as closely as possible and provide as much relevant information and documentation as you can.
A strong SSDI application will contain a complete record of your disabling condition and its impact on your life. Key evidence may include medical records from all your health care providers, a thorough account of your work history, and detailed information about the functional limitations you experience due to your disability.
Work history is also important because you must have sufficient work credits to be eligible for SSDI. In addition, the SSA claims examiner will use the information you provide about your work history to determine what kind of work you are still able to do. Provide detailed information about your job duties and responsibilities. In particular, note the physical requirements of your jobs and the challenges posed by your medical condition to establish its effects on your job performance.
A common reason the SSA denies SSDI applications is insufficient documentation. Working with a disability advocate can ensure you present the strongest possible application for benefits
Step 2: Initial SSDI Claim Review
The majority of initial applications for disability benefits—roughly two-thirds—are denied. The SSA closely evaluates initial claims for evidence of ineligibility, such as insufficient work credits to qualify for SSDI or unsupportive medical documentation of the alleged disability.
A denial on the first try isn’t the end of the line for your SSDI application. The experienced SSDI attorneys and disability advocates at Disability Advice can review your case, analyze the reasons for the SSA’s denial, identify any holes in your application, and help you build a compelling case for reconsideration.
Step 3: Requesting Reconsideration After a Denial
After receiving an initial denial, you have 60 days to request reconsideration of your claim. You can submit additional documentation to strengthen your application, which will then be reviewed by a senior SSA officer other than the person who denied your claim.
While the success rate at the reconsideration level is relatively low, it’s a necessary step in the appeals process. Appeals at the higher levels have a much higher success rate. For instance, more than 50 percent of hearings result in benefits approvals. Thus, you still have a good chance of approval even after receiving an initial denial.
Step 4: The Disability Hearing Process
Unfortunately, your claim will likely be denied at the reconsideration level. If it is denied, you have another 60 days to request a hearing before an administrative law judge, or ALJ. The ALJ hearing process is lengthy and can be difficult to manage without the help of a professional.
Preparing for an ALJ hearing involves gathering documentation of your disability and limitations, preparing your testimony, and otherwise building a complete and compelling case. Vocational experts and other professionals may also testify. Thus, you will need to prepare to question them.
While there is no way to guarantee a favorable outcome, representation by an experienced attorney or advocate at the ALJ hearing gives you the best chance of success.
Step 5: Appeals Council & Federal Court
It usually takes roughly 30 days to receive a written decision from an ALJ. After you receive your decision, you have another 60 days to request review by the SSA Appeals Council. The Appeals Council may return your case for another ALJ hearing or may issue a decision without another hearing.
If your claim is unsuccessful before the Appeals Council, you can file a civil lawsuit in federal district court. A federal lawsuit is your last opportunity to receive SSDI benefits on your existing application.
This stage of the process can take years and is very difficult to manage on your own, from initial filing to representing yourself in court. If you choose to pursue a federal suit, the process is significantly easier to undertake with the assistance of a disability benefits attorney.
How Long Does the SSDI Approval Process Take?
The SSDI approval process can be lengthy depending on your circumstances and the SSA’s case backlog at the time of your application. Expedited claims for severe illness take significantly shorter than denied claims requiring an appeal.
It usually takes about seven to eight months to receive an initial response after submitting your initial application. If your application is denied, you have 60 days from the date of denial to request an appeal.
Requesting an appeal places you in the reconsideration stage, which typically takes roughly four to six months. If your application is denied again, you have 60 days to request a hearing before an ALJ.
After you’ve appeared before the judge, you will receive a written decision from them, usually within 30 days. However, it can take months for a hearing to be scheduled due to the high number of cases, meaning that this stage typically takes 270 to 280 days altogether.
If the ALJ denies your claim, you can request reconsideration from the Appeals Council and may ultimately file a lawsuit in federal court. This stage of the process often takes years.
Tips for Improving Your Chances of Approval
Denials are common during the SSDI application process. There are a few tips to keep in mind to help you succeed on your first application or successfully appeal a denial:
- Provide complete and consistent medical records. Many SSDI applications are denied because of insufficient medical evidence of the applicant’s disability. Including a complete record of all medical treatment you’ve received from all your health care providers can significantly improve your chances of approval.
- Include a detailed work history and evidence of your functional limitations. A thorough work history and proof of functional limitations are critical parts of a successful SSDI application. Ensuring your work history is complete and clearly establishing your functional limitations can give you a better chance of approval.
- Work with an experienced disability advocate. It’s difficult to navigate the SSDI claims process on your own. Working with an experienced disability advocate means you have a knowledgeable ally in your corner who can help you avoid common errors and maximize your chances of success.
What To Do if Your SSDI Claim Is Denied
Denials are extremely common during the SSDI approval process. Fortunately, receiving a denial doesn’t mean your chances of receiving SSDI benefits are over. If your claim has been denied, you can pursue reconsideration, request an ALJ hearing, and put your case before the Appeals Council or a federal judge if necessary.
If you’re considering appealing your denied claim, don’t wait to get legal help. Reach out to Disability Advice for your free legal consultation today.
- Free case evaluation
- Assist with denied claims
- Ensure you have all documents
- Make the process easy for you
Written by:
Linda Cosme – Vice President of Disability Policy & Strategy, Citizens Disability
“Professionalism at its best. From intake to getting my claim started, they are the ones you need. 100% recommend to everyone.”
Pablo P.
“Having never gone through this process before, it was very easy and straightforward. VERY professional and polite.”
Alan A.
“I had a great experience with my representative. She was very friendly and she made the process very easy. I’m glad I had the pleasure to work with her in filing my claim. She provided great customer service.”
Dana C.
“I was very nervous about reaching out for help with disability benefits. This experience was so much easier than what I thought it would be. They were understanding and supportive, and answered all of my questions. I would highly recommend them.”
Alice P.
“One of the best customer service experiences I have ever had. Patient and kind and couldn’t of made my experience better. Thank you for all the help.”
Jama M.
“I was very pleased and impressed by the advocate. I feel that my chances of receiving my disability benefits are more likely to come in a timely manner.”
Danny C.
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“Professionalism at its best. From intake to getting my claim started, they are the ones you need. 100% recommend to everyone.”
Pablo P.
“Having never gone through this process before, it was very easy and straightforward. VERY professional and polite.”
Alan A.
“I had a great experience with my representative. She was very friendly and she made the process very easy. I’m glad I had the pleasure to work with her in filing my claim. She provided great customer service.”
Dana C.
“I was very nervous about reaching out for help with disability benefits. This experience was so much easier than what I thought it would be. They were understanding and supportive, and answered all of my questions. I would highly recommend them.”
Alice P.
“One of the best customer service experiences I have ever had. Patient and kind and couldn’t of made my experience better. Thank you for all the help.”
Jama M.
“The person I spoke with was very knowledgeable and very thorough with answering all of my questions and making sure all my information was correct. He was very patient, kind, and was very helpful. I wasn’t sure if I would qualify, and he checked and took all of my information. The process was made very easy, thank you so much for your help.”
Patrice I.