Once you have submitted your application, the SSA may request that you be examined by one of their consulting doctors. This generally happens if they don't feel they have adequate information from your regular doctor(s) to make a determination. If you're asked to do this, be sure to keep the appointment, cooperate fully with the doctor, and answer any questions honestly.
According to the SSA, it usually takes about three to five months from the time you submit your application to get a decision. Approximately 35% of claims are approved at this stage. If your claim is denied, don't give up. Most claims are not approved without going through the appeals process and being heard by an Administrative Law Judge.
The Appeals Processing
There are four possible steps to the appeals process:
• Reconsideration – If your initial SSDI application is denied, you have 60 days to file an appeal. At this point, you need to complete a Request for Reconsideration and an Appeal Disability Report. Both forms can be filled out online or you can request them from your local SSA office. Someone at the State Disability Determination Services office will review your medical records (not the same person who made the initial determination) and make a new determination. Only about 15% of appeals are approved at this level.
• Hearing – If your appeal is denied, you have 60 days to request a hearing before a judge. Again, you'll need to complete two forms: a Request for Hearing by Administrative Law Judge and an Appeal Disability Report. As before, both forms can be filled out online or you can request them from your local SSA office. At this point, most people seek representation by an attorney or other qualified representative. Although you can get a representative at any point in the process, it's highly recommended when you're preparing for a hearing. Lawyers take SSDI cases on a contingency basis – if you don't win, they don't get paid. If you do win, fees are set by the SSA. Your legal representative will receive either 25% of the back benefits you receive or $5,300, whichever is less. The good news is that nearly 70% of claims are approved when heard by a judge.
