What Are The Steps In The Social Security Disability Application and Appeal Process?

The first step in the disability process is to actually apply for Social Security disability benefits. You can file an application for Social Security disability (SSDI) benefits by phone, by mail, online or in person at your local Social Security Administration District Office. Your lawyer can help you file your application.

A claim for Supplemental Security Income (SSI), on the other hand, must be done in person at the local Social Security office or by phone appointment with an SSA Representative.

Your disability claim will then be processed by a representative from your local Social Security field office, and by and your state agencies.  The Social Security representative will verify your age, marital status, employment and whether you have enough work credits to qualify for SSDI benefits by having paid Social Security taxes into the system. Your file is then sent to Disability Determination Services (DDS) to determine whether your medical condition is disabling. The DDS is responsible for gathering the required medical records from your doctors.  DDS may also make arrangements for you to be seen by consultative examining doctors (that are paid by the Social Security Administration) to determine the severity of your impairments.

Once DDS determines they it has enough medical evidence, it will issue the first decision as to whether you are disabled under the Social Security disability regulations. If you meet the medical requirements for disability the DDS will return your file to the local Social Security field office to calculate the amount of your disability benefits, and you will then begin receiving those benefits. If the DDS finds you are not disabled, then the file is still sent back to the Social Security field office where they will wait to see if you appeal the decision.

To appeal the decision in the state of Florida you must go through the process of reconsideration. You must file a Request For Reconsideration, which is basically a repeat of the initial claim process. [Note: In other states, such as Alabama, if you appeal your initial denial you will skip the Reconsideration stage and go straight to the hearing stage before an Administrative Law Judge.]

If you are denied on reconsideration, then you proceed to the hearing stage.  Your case is now in another office called the Office of Disability Adjudication and Review, or ODAR for short. The ODAR that covers Pensacola, Florida is in Mobile, Alabama.  The average wait time for a hearing is extremely long, with national averages ranging from 12-18 months (and sometimes longer). As of March 2013, the Mobile ODAR had a wait time of 13 months. And that is not calculated from the initial application. That wait begins at the time the Request for Hearing is filed. If you win at the hearing stage (and your case is not reviewed by the Appeals Council), it will be sent to the local field office for payment.

If the Administrative Law Judge issues a “Notice of Decision – Unfavorable” and you lose at the hearing stage, you can appeal the decision to the Appeals Council.

The Appeals Council will do one of three things: deny your appeal, remand the case for another hearing, or find you disabled. If you continue to lose at the Appeals Council your only recourse is to file a civil action (lawsuit) in United States Federal Court.