The Social Security Disability Process Visualized: From Application to Award

Required Reading

If you're disabled and unable to maintain steady, substantial employment, you should be able to win disability benefits without too much hassle. Unfortunately, the social security disability system often makes getting benefits an uphill battle.

Find information about relevant parts of the Social Security Disability claims process in this sidebar.

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Applying for Benefits

• How to Win a Social Security Disability Claim Faster
• How to File for Social Security Disability
• When Should You Apply for Disability?
• What Medical Evidence Will You Need?
• How to Find a Doctor to Help with Social Security Disability

Technical Issues

• What is a Technical Denial?
• How Much in Assets Can I Have?
• SGA: Substantial Gainful Activity
• Can You Work and Apply for Disability?

The 5 Step Evaluation

Social Security Review Process

• The Social Security Disability Review Process
• How Long Does It Take to Get Approved for Social Security Disability Benefits?
• The Social Security Definition of Disability
• Tips for Winning Your Disability Case
• What to Do If Your Claim is Denied

Don't Give Up on a Denied Claim

Many people (over 50%) give up once their initial SSDI or SSI claim is denied. This is a mistake. If your claim is denied, that doesn't mean you don't have a good case. If you want to successfully win social security disability benefits, chances are you will need to see your case all the way through to the administrative hearing level.

Starting Your Appeal

• The Disability Reconsideration Review
• How to Request a Social Security Disability Appeal Hearing
• How to Start the Appeal Process
• The Disability Appeal Success Rate

Speeding Up the Appeals Process

Some states will allow you to skip the reconsideration appeals level and go straight to the judge. You may also request an expedited review if your condition is serious.

Learn More:
Get Your Social Security Disability Hearing Scheduled Faster

The Administrative Hearing

• The Disability Hearing
• Wait Time for a Hearing
• The Administrative Law Judge (ALJ)
• What to Expect at the Hearing
• What Happens After Your Disability Hearing?

If the Judge Denies Your Case

• Can You Get Another Hearing if a Judge Denies Your Claim?
• Social Security Appeals Council
• Can I Win at the Appeals Council?
• What if the Appeals Council Denies Me?

Tips for a Successful Disability Claim

1. Continue Medical Treatment. Social security is much more likely to award you disability benefits if you can show you are trying to treat your impairment.

2. Get Your Doctors' Help. If your doctor is willing to write a statement supporting your claim of disability, this will be a great advantage at the hearing level.

3. Apply Early. As you can see, the social security process can take a long time. You'll want to apply as soon as possible to get benefits as quickly as you can.

4. Get Representation. If you've been denied benefits, it is especially helpful to have an attorney or advocate make your case for you. Having a professional handle your case gives you a much greater chance at an award.

Once You've Won

1. Amount of Benefits. The amount of money you receive as social security disability benefits will depend on how long you've been disabled and how much you have paid into Social Security over your working life.

2. Back Pay. Part of your disability award will include all the money you should have been receiving while you were making your case. This amount is paid as a lump sum, and is often a large amount of money simply because the process can take so long.

3. Keeping Your Benefits. By definition, social security payments are made as long as you remain disabled. If your condition improves to the point where you are no longer considered disabled, or if you begin working above the SGA limit, you will no longer be eligible for disability benefits. Social security will require that you complete a "continuing disability review" every few years.

Basics of a Social Security Disability Claim

If you are unable to work as a result of a condition or impairment, you may be able to qualify for benefits through the social security administration.

Disability Programs Available

Two programs are available that allow individuals to qualify on the basis of disability:

• Supplemental Security Income (SSI) is for those whose income and resources are below a set level and who also have some other criteria that allows them to qualify, like a disability or advanced age
• Social Security Disability Insurance (SSDI) is for those who have acquired a sufficient amount of work hours based on their age at the time of becoming disabled and are no longer able to sustain employment.

To qualify for either program, there is a similar process you must go through.

Qualifying for Disability Benefits

The first step in the process of getting disability benefits is making sure you qualify for those benefits. There are many different criteria looked at by the SSA. Some of the factors that may be considered include the following:

Whether you are capable of substantial gainful activity. This refers to whether you are working and earning an income. The amount you may earn changes yearly, but as of 2021, if you are making an income of more than $1,310 per month, you can be considered to be engaged in substantial gainful activity.

Whether you have a disability that is expected to last for 12 months, that already has lasted that long, or that is terminal.

Whether your disability is listed in the SSA "blue book" listing of impairments and you meet the specific symptoms that must accompany that particular disability or whether your condition is medically equivalent to the disabilities listed.

Whether your disability interferes with your ability to perform routine activities of daily living (ADL) like showering, bathing, dressing or otherwise caring for yourself.

Whether your disability interferes with your ability to work at the job you have now, a job you have had in the past, or a job to which your vocational skills may be able to be transferred.

All of these factors can play a role in whether you qualify for benefits. The basic aim is to make sure that only those who really do suffer from a significant impairment, and only those who cannot earn a living because of it, are able to get SSA benefits.

Applying For Benefits

Assuming you meet the qualification requirements and you indeed do have a severe enough disability, the next step in the process is to actually fill out an application for benefits. You may obtain applications from your local social security office, or by visiting the disability section of the Social Security Administration website.

Learn more about Filing for Social Security Disability Benefits.

Work History & Medical Evidence

You will be asked to provide information about your personal history, medical history and work history. You will need to sign a release allowing the SSA to get your medical records, and you will need to show why your disability qualifies you for benefits. Applications should be signed and then mailed in or delivered in person.

Initial Review

Your initial application will be checked to ensure that all required elements are there and that you meet basic qualifying criteria. Your claim will then normally be assigned to a special disability claims reviewer/examiner, who will look at all of your medical documentation.

Some Cases Require Additional Information or a Medical Examination

There may be additional things asked of you at this point, such as a request to come in for an interview or to have a consultative examination where a doctor working for the SSA will conduct additional testing or interviews. The process of having a claim evaluated initially can take anywhere from three months to five months on average, but it may sometimes take much longer. Appeals, if your initial claim is denied, will add significant time to the process.

Getting Help with Your Disability Case

If you wish to apply for social security benefits as a result of suffering from an impairment or disability, or if you've been denied benefits, it is in your best interests to get a lawyer's help in doing so. A lawyer can explain to you exactly what requirements you have to meet and can assist you in all the steps of convincing the SSA that you are deserving of benefits.

_{Updated October 12, 2022}