The Social Security Disability Process Visualized: From Application to Award

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 sometimes makes getting benefits an uphill battle.

Here's how the SSDI and SSI disability determination process works, how to file an appeal, and your chances of getting benefits at each stage of the process.

Basics of a Social Security Disability Claim

If you're unable to work as a result of a condition or impairment, you might be able to qualify for benefits through the Social Security Administration (SSA) if you qualify both financially and medically.

Financial Eligibility

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

• Social Security Disability Insurance (SSDI) is for people who have worked a sufficient number of years, based on their age at the time of becoming disabled, and are no longer able to keep working.
• Supplemental Security Income (SSI) is for people whose income and resources are below a set level and who haven't worked enough to be eligible for SSDI.

To qualify for either program, the SSA has a similar process you must go through.

Medical Severity: Five-Step Evaluation

The first step in the process of getting disability benefits is finding out whether you meet Social Security's definition of disabled. The SSA has a five-step evaluation process that it uses to decide if you're disabled.

1. Are you doing "substantial gainful activity" (SGA)? Social Security has a dollar amount threshold for what's SGA, and it changes yearly. As of 2025, if you're making an income of more than $1,620 per month (after some generous deductions), Social Security will find that you're engaged in substantial gainful activity and will deny your claim.

2. Do you have a severe impairment that's expected to last for 12 months? Social Security wants to see objective medical evidence (like lab results or signs from a clinical exam) from an "acceptable medical source." The evidence must show you have a condition that interferes with basic work activities like walking, lifting things, or following instructions.

You don't have to be off work for 12 months before you apply, but Social Security needs to believe that you won't be able to work for at least a year due to your condition.

3. Is your disability listed in the SSA's "Blue Book" listing of impairments, and do you meet the specific symptoms required for that disability? Social Security has a listing of medical criteria for over 100 conditions that are considered so severe that you'll be found disabled if your signs and symptoms match them.

If you can't meet a listing (it's not easy), Social Security will assess your capacity for full-time work. The SSA will create a "residual functional capacity" (RFC) for you, a list of work functions you can and can't do for eight hours a day, five days a week.

4. Does your disability prevent you from working at a job you've had in the past five years? Social Security will compare the functions in your RFC to the requirements of recent jobs you've held to see if you still have the capacity to do them. If you're still able to do each function of one of your past jobs, you're not disabled.

5. Does your disability prevent you from doing another type of work? Social Security will try to identify other jobs that you could switch to that are within your RFC capabilities. If you're over 50, Social Security will look at your educational level and past job skills in deciding whether you're capable of learning a new type of job.

How to Start the Disability Process

Assuming you meet the qualification requirements and you have a severe enough disability, the next step in the process is to fill out an application for benefits. You have four options for applying for benefits.

1. Complete the online application. You can pause and resume the online application process as often as needed without losing your place.

2. Complete the application over the phone. Call the SSA at 800-772-1213, between 8 a.m. and 7 p.m., Monday through Friday. (People who are deaf or hard of hearing can call the TTY number at 800-325-0778.)

3. Apply for disability benefits in person. You can get help filling out an application at your local Social Security office. Contact the field office and make an appointment ahead of time to avoid a long wait.

4. Hire an attorney or representative to file your application for you. Learn when it makes sense to hire a lawyer or advocate.

Learn how each application method works and which makes the most sense for you.

Information Needed by Social Security

Here's what to expect when you apply for disability benefits from the SSA.

Your Work History and Medical Evidence

You'll be asked to provide information about your personal history, medical history, and work history. You'll need to sign a release allowing the SSA to get your medical records, and you'll need to show why your disability qualifies you for benefits.

Additional Information or a Medical Examination

A special disability claims examiner will look at all of your medical documentation and employment history. The examiner may ask you to do additional things at this point, such as a come in for an interview or attend a "consultative examination," where a doctor who is paid by the SSA may conduct additional testing or examinations.

The process of having a claim evaluated initially can take anywhere from three months to eight months on average, but it can sometimes take longer.

Don't Give Up on a Denied Claim

Many people (over 60%) 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 have a bad case. You might have left out some information or made some mistakes on your application. Or, your condition might have gotten worse since you applied, giving you a better chance of winning benefits on appeal.

If you want to successfully win Social Security disability benefits, chances are you will have to see your case through to the disability hearing level.

Social Security publishes a "waterfall chart" each year with facts and figures about how many applicants get approved at each stage of the disability process. In the chart below, you can see that only 38% of applicants get approved at the initial (application) level. And very few (16%) are approved at the first level of appeal, called "reconsideration" (where a different claims examiner reviews your file). But at the next level of appeal, the disability appeal hearing, 51% of applicants are approved. Over two-thirds of applicants who are denied at the reconsideration step request a disability hearing so that they can have a judge review their case.

The lowest rates of approval happen at the Appeals Council, which is within the SSA, and federal court. But the Appeals Council and federal court send back ("remand") a lot of cases to the hearing level for the judge to take another look at the case.

This data is for fiscal year 2024 (October 2023 through September 2024), the latest available from the SSA. (Note that the data for the federal court level of appeal includes outcomes for continuing disability reviews.)

Tips for a Successful Disability Claim

1. Continue getting medical treatment. Social Security is much more likely to award you disability benefits if you can show you are trying to treat your impairment, and having a regular treating doctor makes it more likely that you'll have the proper medical evidence to win your claim.

2. Get your doctors' help. If your doctor is willing to write a statement supporting your claim of disability, listing your limitations and evidence to back them up, it will be a great advantage at the hearing level.

3. Hire legal representation. If you've been denied benefits, consider hiring an attorney or advocate to make your case for you. Having a professional handle your case gives you a greater chance at an award.

Frequently Asked Questions

The following articles on our website answer our most commonly asked questions. Reading them can make you feel more comfortable with the process and help you win disability benefits.

Applying for Benefits

• When Should You Apply for Disability?
• What Medical Evidence Will You Need?
• How Can I Find a Doctor to Help Me Get Disability?

Eligibility Issues

• What Is a Technical Denial?
• How Much in Assets Can I Have?
• Do I Have to Quit Work to Get Disability?

Social Security Review Process

• How Long Does It Take to Get Approved for Social Security Disability Benefits?
• How Can You Get Your Social Security Disability Hearing Scheduled Faster?
• What Should I Do If My Claim Is Denied?

After the Disability Hearing

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

_Sources:

• _{Fiscal Year 2024 Workload Data: Disability Decisions, SSA Jan. 2025}
• _{Fast Facts & Figures About Social Security, SSA Sept. 2024}