Social Security Disability and SSI: The Application and Determination Process

To apply for Social Security disability insurance (SSDI) or SSI benefits based on disability, a person must first make a claim (fill out an application). You can do this by contacting the Social Security office, either by phone or by visiting a local office. Some people can file online:

• adults applicants for SSDI
• adult applicants for SSI who:
  • have never been married
  • have not applied for SSI in the past
  • are not applying for blindness or low vision, and
  • are also applying for SSDI.

Initiating Your Disability Claim

As many individuals can attest, getting through on the phone to apply for Social Security can be a difficult task in itself. On the other hand, trying to talk to someone as a walk-in at your local Social Security office can mean hours of waiting simply to be given an appointment to return at a later date.

It's probably better to call first for an appointment. You can arrange for a phone interview rather than an interview conducted in-person, if you want. Interviewing over-the-phone is typically more convenient than traveling to the Social Security office.

If you don't want a field representative's help in walking you through the application process, you may want to file online.

Disability Determination Process

Although disability applications are filed at the Social Security office, that is not where they are evaluated. Disability applications are actually sent to state disability agencies, usually called Disability Determination Services, or DDS for short. At DDS, claims are assigned to disability specialists known as disability claims examiners. Examiners are the individuals who make the initial decisions on Social Security cases.

How long a Social Security disability case stays at DDS depends on many factors, such as how many cases a particular examiner has and how long it takes an examiner to gather a claimant's medical information. Consequently, a claim may be at DDS for as little as a month, or as long as several months. There is really no way to know, even for the examiner, how long a Social Security disability case may take. Therefore, when Social Security advises that a decision will be made within 90 to 120 days, take this with many grains of salt.

Follow Up with DDS

Because DDS processes claims, it doesn't make sense to call the SSA to inquire about the status of the claim while the claim is at the DDS. It does make sense to contact the disability examiner while the case is at DDS. This is for several reasons:

• The disability examiner usually knows what is happening on a claim and can readily provide the information.
• Examiners who are bugged by applicants tend to work on their claims faster (naturally, to avoid more phone calls).
• Unlike the Social Security office, DDS is easily accessible by phone (our state disability pages include contact information for your state's DDS).

What Happens at the DDS

In the course of working on a benefits claim for Social Security or SSI, a disability examiner may do one or more of the following:

• Send letters to the claimant's medical sources (doctors, hospitals, and clinics) to request medical records.
• Make calls to the claimant, or the claimant's friends or relatives, to gather information about the claimant's conditions (ADL calls).
• Confer with medical specialists (physicians, psychiatrists, and psychologists) employed by Disability Determination Services (required in most states).
• Send the claimant to a medical examination paid for by DDS if there is not enough information in the claimant's medical records.

What usually delays a claim is waiting for medical records information to be received. Therefore, whenever possible, you should obtain your own medical records for disability and submit them when you apply (making sure, of course, to keep a copy for yourself--Social Security has a habit of losing information that's needed for a disability claim). That way, DDS doesn't have to wait until your doctor sends the records to the DDS.

Usually, once an examiner has all the medical evidence gathered, a claim decision follows shortly. Find out more about how the disability examiner decides whether you are medically eligible for disability benefits.