An Overview of The Social Security Disability Claims Process

The initial stage takes place after you file a Social Security Disability claim with the Social Security office. Your original claim is reviewed by a disability examiner working at the Disability Determination agency in your state. This disability examiner will review your file, medical records, and other important information and consult with a doctor to determine if you are disabled and eligible for Social Security benefits. Unfortunately, the claimant will typically not know the identity of his or her disability examiner, and will have no personal contact with the examiner. Overall, 60% of the claims at this stage are rejected.

If the disability examiner rejects your claim, which is very typical, you can request an appeal called “reconsideration.” Reconsideration, as the name suggests, is less like an appeal and more like asking Social Security to take a second look at your claim and “reconsider” its decision. As in the initial stage, another disability examiner in your local Disability Determination agency will review your claim and issue a decision. Also, as before, the claimant will not have any personal contact with the examiner. Generally, 80% of the claims at this stage are rejected.

If the disability examiner rejects your claim after the reconsideration stage, the claimant can again appeal and request a hearing with an administrative law judge. At the hearing stage the claimant will actually takes his case before a live judge in hopes of receiving a different decision. Though this might seem intimidating, this is typically the first stage in which the claimant will be able to present his case and talk with the decision maker. The hearing is informal compared to most legal settings, and typically will include the claimant, the claimant’s attorney, the administrative law judge, his secretary, and a vocational expert to testify as to the claimant’s disability and limitations. The hearing will not have a jury or an audience, and Social Security will not be represented by an attorney. After reviewing the claim, the judge will determine if the claim is valid independent of the prior decisions of the disability examiners. Statistically, over half of the claims at this stage are successful.

If you are unsuccessful at the hearing stage, you can appeal to the Appeals Council. The Appeals Council is a single body located in Falls Church, Virginia, that will review the administrative judge’s decision if you are unsuccessful. The Appeals Council only reviews the judge’s decision and does not hear arguments from the claimant or claimant’s attorney.

If the claimant is rejected by the Appeals Council, you can take your case to the federal courts. First you would file in a United States District Court, but you could potentially appeal all the way up to the United States Supreme Court. It’s important to remember that the United States District Court appeal is the first appeal that is handled outside the Social Security bureaucracy.

As detailed above, the Social Security Disability claims process is complicated, tedious, and time consuming. As with any difficult scenario, it is helpful to have experience on your side, and that’s exactly what we offer. An experienced attorney can help you navigate Social Security’s bureaucratic maze and save you time and heartache.