How Long Must I Wait For a Social Security Disability Hearing?

Most individuals, unless they've had a friend or relative who has become disabled, never even realize that there is such a thing as "social security disability" or "SSI disability". Even I, who had previously worked as a caseworker in nearly every federally mandated program, knew practically nothing about the disability benefit programs administered by SSA (social security administration) until I applied for a job as a disability examiner. For most individuals, an awareness of social security disability or SSI only comes when they begin to have serious medical or mental health programs and are forced to investigate their available options for financial survival. But in a nation that, statistically, is becoming older, this prospect is increasingly more likely.

Each year, approximately two and a half million individuals file for Social Security disability, not knowing at all what's in store for them. This is what they find out: Two thirds of all initial disability claims are denied; unfortunately, due to a variety of reasons (including, I believe, a failure of SSA to properly educate claimants regarding their appeal options), many individuals decide not to continue their disability claim at this juncture. In other words, they don't appeal.

However, according to one estimate, roughly six hundred thousand individuals do go on to utilize the Social Security disability appeals process. In most states, this means filing something known as a request for reconsideration. And at this stage of the process, things can seem even more dismal: though the numbers vary, depending on the state in which you live, about 80 percent of all reconsideration appeals are denied.

How much time has been consumed at this point? SSA has no way of knowing just how long it will take an individual to go through the disability process, nor is there any set amount of time in which Social Security is required to move a case along at the initial claim level, reconsideration level, or, later in the process, to set a hearing date with an administrative law judge.

Most disability claimants receive their initial disability decision in roughly three to four months (SSA typically quotes an average and expected processing time of "one hundred and twenty days") though there are plenty of exceptions that drag on for longer periods of time. Often, those involve situations in which medical records are difficult to obtain, claimants repeatedly miss appointments for consultative medical exams (sometimes due to valid and extenuating circumstances and sometimes not), or where surgical procedures have been performed at the same time that a disability case is pending (such as subsequent heart procedures that require a case to be put on hold for an three extra months so social security can evaluate a claimant's medical response, i.e. did they get better or worse?).

However, the wait for a hearing is easily the largest component of the social security disability waiting game. The national average wait time for a Social Security disability hearing was over five hundred days in 2008, which meant that some hearing offices had longer wait times.

As you might well imagine, many individuals experience extreme financial hardship while waiting for a Social Security disability hearing. For most, there is very little that can be done to speed up their wait time.

Some individuals may be able to expedite their hearing, by providing Social Security with a dire need request. Your dire need letter should furnish enough information to explain the severity of your situation; and it doesn't hurt to attach late notices from your utility companies, mortgage Company, or landlords. Sometimes a dire need letter may result in your hearing being scheduled sooner, however there are no guarantees and, unfortunately, financial ruin often goes hand in had with the Social Security disability process.

If you continue the Social Security disability process to the administrative law judge hearing, statistically you are more likely to be approved for disability benefits than not.

In fact, national statistics suggest that as many as two thirds of all disability claims that go before an administrative law judge are approved for benefits.

For this reason, then, more than any other, it should never enter the mind of an applicant for disability benefits to ever give up on their claim. Of course, as the title of this post suggests, the wait for a hearing (the second appeal in the process, following the denial of a reconsideration appeal) can be considerable. Currently, it can take up to two years, depending on where you live in the country and how backlogged the hearing office that has jurisdiction for your area is. And in some cases, it can take longer. But, by the same token, not all hearing requests will take so long.

Regardless, though, of whether a request for a hearing takes six months or two years-plus, this fact (the interminable wait) highlights the importance of maximizing one's chances of winning a claim early on, if at all possible.

Can you, the claimant, actually do anything to improve your chances of winning your claim at the initial claim or reconsideration appeal level? Actually, the best way to approach the topic is to say that there are a number of mistakes a claimant can avoid that may disadvantage their claim and slow down the processing of their case.

In a future post, I will discuss this more at length. In the meantime, here's a link to a section on www.disabilitysecrets.com that discusses various mistakes for disability claimants to avoid.

Social Security Disability Mistakes








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Can You Win Disability Without Going to a Hearing?

Yes, of course. And a very large percentage of applicants for social security disability and/or SSI disability do win their cases without the need for requesting a disability hearing.

Statistical data indicates that, on a national level, roughly thirty to forty percent of all disability claimants win their claim for disability at the initial level (this varies substantially depending on your actual state of residence). At this level, most individuals meet or equal a listing in the disability impairment handbook or are a clear-cut medical vocational allowance (generally these individuals are approaching advanced age 50-54 or are advanced age 55-older). Medical vocational allowances, for those who are unaware, are approvals that are rendered based on a consideration of a claimant's residual functional capacity (your medical records are evaluated to determine what you can and cannot do), work history, and other considerations such as age and level of education.

If you initial disability claim is denied you must appeal your disability denial to continue the disability process. Just a piece of advice here, many individuals are so discouraged when their initial disability claim is denied that they do not appeal their denial. But remember, sixty to seventy percent of all initial disability claims are denied and, of those who decide to file a disability appeal (and a second appeal, if necessary), a sizable percentage are eventually awarded benefits.

What should you do if your disability claim is denied? Not wait any appreciable length of time before getting your appeal started. Though social security allows a lengthy timeframe (60 days plus an additional 5 days for mailing) for filing a disability appeal, waiting means simply putting more time between you and potentially receiving disability benefits.

You need to request a reconsideration appeal. Your disability claim will be sent "back down" to the same state disability agency for another medical determination, however a different disability examiner will review your record and request any medical updates that you provided in your reconsideration request. Although it is somewhat rare for a disability claimant to win their disability benefits at this level of the disability process (only about 15 percent win their disability), it is another stepping stone in the disability process. And a very important one. Because you cannot get your case to the disability hearing level without first going through the reconsideration appeal phase.

However, returning to the question with which we started, can you win your social security disability without going to a hearing? The answer to this question is that, depending on the state in which you live, between 40 and 50 percent of all disability claimants win their disability benefits without ever going to a hearing.









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Social Security Disability Request for a hearing before an administrative judge

The disability hearing is very different from any other step in the social security disability claim system. It is different in the respect that, for the first time since filing for disability, a claimant will actually get to meet the individual who is deciding the outcome of their claim. However, it is also different in several other regards. For example, though a claimant can obtain representation at any step of the process, the hearing, too, is the first opportunity for the representative (attorney or otherwise) to meet the decision-maker (who, in this case, would be a federal ALJ, or administrative law judge).

In being able to meet the disability judge, both the claimant and their representative have the opportunity to present new evidence (though, typically, this is submitted prior to the hearing), point out deficiencies in prior denials of the case at the initial claim and reconsideration levels, and argue the merits of the case (i.e. how the medical evidence warrants an approval of benefits based on the claimant's mental or physical limitations and the vocational factors that apply). For these reasons, among others, the hearing level represents the best chance, for those who have been previously denied, of being approved for social security disability or SSI.

And because this is true, a claimant who has been scheduled for a disability hearing or simply has a pending request for a hearing should ensure that their case receives the best possible preparation and development.

Here are a few answers to basic questions about social security hearings for disability benefits.

1) When can you file for a social security hearing? Though, statistically, the hearing represents the best chance of ultimately winning benefits after a disability application has been denied, a claimant is not allowed to immediately request a hearing after the initial denial. Instead, claimants are required to first file something known as a request for reconsideration. The reconsideration is the first appeal and the reconsideration process is no different than the disability application process. Reconsiderations, like disability applications, are handled by disability examiners who work in state disability processing agencies where disability claims are decided for the social security administration.

As with applications, reconsiderations involve gathering and reviewing medical evidence and rendering a decision based on social security rules and disability criteria. However, unlike disability applications, reconsiderations are denied at a significantly higher rate. Where approximately seventy percent of applications are denied, approximately eight-five percent of reconsiderations are denied. This fact makes the reconsideration appeal step seem rather useless to most claimants and attorneys. However, after a reconsideration has been denied, a claimant may file a request for a hearing before an administrative law judge.

2. What are the odds of success at a disability hearing? Actually, quite good. About half of all SSD and SSI disability claims that are brought before judges are approved. For those with representation, the percentage is even better, a little over sixty percent. Why are more cases won where attorneys and non-attorney representatives are involved? Typically, this is because disability representatives know how to prepare cases, in terms of gathering medical evidence, and know how to succesfully argue the merits of a case, based on knowledge of the federal disability system (including concepts such as substantial gainful activity, closed periods, unsuccessful work attempts, residual functional capacity, and the medical vocational grid, the rules of which determine many disability determinations).

3. Are you required to have an attorney for a disability hearing? No, and in fact, you, as a claimant are not required to have representation at any step of the process, from initial claim to reconsideration to disability hearing to appeals council, and even to federal court (a non-attorney cannot represent you in federal court, but you can represent yourself in federal court). Will you benefit from having a disability attorney at a hearing? Let's put it this way. Your case may be good enough to be allowed by a judge, regardless of whether or not you are represented. There are those cases, it's true, that are winners from the word go at the hearing level. But...most cases are won because judges are given what is needed to win a case---medical documentation and a solid argument that the case meets the social security definition of disability.

So, you're not required to have a representative, but if you want to enhance your chances of winning your claim, its not a bad idea to get one.

4. How long does it take to get a disability hearing? Depending on where you live and how bad the hearing backlogs are in your state, it may possibly take up to two years to get a hearing scheduled after the request has been made. For this reason, claimants who get denied should always file their appeals immediately. I.E. don't add any more time on to the process because the process is already long.

5. Where are disability hearings held? For the most part SSD and SSI disability hearings are held are hearing offices, as long as the hearing office is not so far away from where the claimant lives that it presents a hardship to the claimant to get there. However, there are instances in which a claimant cannot reasonably be expected to travel the necessary to get to a federal hearing office. In those cases, satellite offices are sometimes set up in areas closer to the claimant, such as a conference room at a local bank.

6. How do you prepare for a disability hearing? This is potentially a very long answer, but it can be boiled down to this: knowing why the case was denied on the prior decisions and then either presenting a rationale as to why those decisions were incorrect, or why the situation has changed, medically, since then.

Preparing for a disability hearing involves getting medical records, statements from doctors, and reviewing a claimant's work history to ascertain if they can go back to their past work, or do some form of other work. If they can do neither, they should meet the definition of disability used by SSA and be approved.

7. What is considered for a decision at a disability hearing? This is the shortest answer on this page: medical records (which include treatment notes, lab reports, admission and discharge summaries, and residual functional capacity) and vocational factors (which include a claimant's age, education, skills, and the types of work they did in the past).






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