Social Security Disability: 5 Step Application Process

Social Security Disability 5 Step Application Process

The initial application for Social Security Disability (SSD) benefits is often only the first step in a more complex process – a process which in some cases can take a year, or several, to complete.

You may need to proceed through five steps or stages before receiving a final decision on your eligibility for SSD benefits. The number of steps required varies by the applicant, and how far you’re willing to go to try to get benefits will also affect the number of steps you complete.

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Step One – Initial Application

The first step in filing a claim for SSD is to complete the full application for benefits. You can fill out your application with the help of a Social Security Administration (SSA) representative, by phone or at your local SSA office, or on your own with hardcopy forms. You can also complete your application online at the SSA’s website (www.ssa.gov).

Since the SSA’s daily office hours have once again been reduced in 2013, an online application is often the most expedient way to file a claim. If you fill out your application with hardcopy forms or online, you’ll need to be as thorough as possible in providing detailed answers and submitting documentation to support your claim. Supporting documentation should include:

  • medical records
  • statements from your treating physician(s)
  • any other records relevant to your claim for disability benefits

No matter which filing method you use, the SSD application consists of the same forms. Required forms include, but may not be limited to:

  • SSA-3368 – Adult Disability Report
  • SSA-3369 – Work History Report
  • SSA-3373 – Adult Functional Report (completed by you)
  • SSA-3380 – Adult Functional Report – Third Party Form (completed by your doctor)
  • SSA-3381 – Adult Medical and Job Worksheet
  • SSA-827 – Authorization to Disclose Information to the SSA

If more information is required to make a decision on your claim, you may receive notices and other forms in the mail. Fill out any forms you get as soon as possible, and return them to the SSA, always maintaining a copy for your own records.

The review of your initial application can take anywhere from just a few weeks to several months. Active involvement in your claim and the collection and submission of any and all requested documentation and information can potentially shorten your wait for a decision. How fast your doctor(s) respond to requests for more information also matters, so check in with them often on their progress.

Step Two – Reconsideration of Claim

When a decision has been made by the SSA on your claim, you’ll receive a notice in the mail informing you of the decision and the reason for denial, if applicable. Your claim may be denied for medical or non-medical reasons. How you request a reconsideration of your claim depends on the reason your application was denied in the first place.

If medical reasons are cited by the SSA as the reason for denial, you can appeal the decision online or request a reconsideration via mail.  To appeal online, visit (https://secure.ssa.gov/apps6z/iAppeals/ap001.jsp). To request a reconsideration via standard mail, fill out the following forms, which can be found in the SSA’s online forms database:

  • SSA-561 -  Request for Reconsideration
  • SSA-3441 -  Disability Report – Appeal
  • SSA-827 -  Authorization to Disclose Information to the Social Security Administration

If non-medical reasons are given by the SSA for why your claim was denied, you can also request a reconsideration by completing form SSA-561. The SSA may send you additional notices and mailings requesting more information, but no other forms are required to initiate a request for reconsideration.

A decision on a reconsideration can take weeks or months, though submitting additional documentation along with your completed forms can potentially speed up the review. When you submit your required forms, include any medical records and other documentation you’ve collected since your initial application was submitted.

Step Three – Appeal Hearing

If denied SSD benefits after reconsidering your claim, you’ll need to file an appeal to continue seeking benefits. A written request for an appeal must be received by the SSA within 65 days of the date that appears on your “reconsideration decision letter”. To satisfy this requirement, you can:

  • request an appeal online (https://secure.ssa.gov/apps6z/iAppeals/ap001.jsp)
  • seek help from your local SSA office
  • fill out and mail the appropriate appeal forms

To know the type of appeal you must file and the form required for requesting it, see the notice you received from the SSA about your reconsideration. There are type-specific appeal forms, and along with the right appeal form, you must also submit:

  • SSA-3441 – Disability Report – Appeal
  • SSA-827 – Authorization to Disclose Information to the SSA

It can take weeks for your appeal hearing to be scheduled, and the date of the hearing can be weeks or months further out in the future. Additionally, the SSA may send you other forms to complete and submit before your appeal hearing being scheduled. Don’t delay returning these forms. Doing so can delay your hearing date even further.

Step Four – Appeals Council Review

If the appeal hearing doesn’t go in your favor, your next step is to request an Appeals Council Review (ACR) of the decision made by the Administrative Law Judge (ALJ) that presided over your appeal in “Step Three”.

You must request an ACR within 65 days of the date on the letter you received about the ALJ’s decision on your claim. Requests must be completed on form HA-520 – Request for Hearing Review. You’ll find HA-5020 available online or at your local SSA office.

Submitting any new documentation you have to support your claim at the same time you send in form HA-520 can potentially shorten your wait for an Appeals Council decision; however, even with all the right documentation and timely submission of forms and records, the review can take several months. This is because the Council randomly chooses pending appeals to review each time they meet.

The Appeals Council rarely finds in favor of the claimant, with only about 2 to 3 percent of all claims being approved at this stage. If you wish to proceed to “Step Five” in the application/appeal process though, you must first go through “Step Four”.

Step Five – Federal Court Appeal

The last step in the appeals process is to file a civil lawsuit in federal court against the SSA. You’ll need a Social Security attorney to file your claim and to handle your case. Your attorney can advise you on the forms and other documentation required for filing and arguing your case.

About one-third of all claims are approved in Federal District Court cases, but the process of suing the SSA is time-consuming and expensive. For this reason, most claimants don’t proceed through this final appeal step. If you choose to move forward with a Federal Court Appeal, you’re likely looking at a wait of a year or more before your court date is scheduled and a decision is made on your lawsuit.

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