These Are the 5 Key Steps in Getting Social Security Disability

Support from Social Security Disability changes your life when health problems have robbed you of your livelihood.

But to make sure people who win benefits truly qualify for disability, the Social Security Administration (SSA) created thousands of rules to follow and multiple steps to get through.

As a result, Social Security has its own special legal system for deciding who gets benefits, and most applications get denied, which is one reason why many people seek help from a disability lawyer. Geary Disability Law, for example, focuses on helping people with this in Wisconsin.

While there are dozens of little steps to putting together your disability claim, there are five major levels to the Social Security Disability process.

That doesn’t mean you’ll have to go through all five levels. Your case will likely be decided somewhere along the way. But below are the major mileposts.

Social Security Disability Step 1: Initial Application

During your initial disability application, you’ll fill out a number of forms, such as a Disability Report (which covers your physical/mental health situation along with the general information needed to start your claim), a Function Report (which describes your functional limitations/abilities), and a Work History Report.

When you’re first applying for disability benefits, you’ll also need to submit medical evidence to Social Security.

Sometimes Social Security will request that you see doctors of their choosing to evaluate your claim.

A reviewer will look at all of your claim documents, and you will be notified of a decision from Social Security on whether your health problems qualify for disability benefits.

Social Security Disability Step 2: Reconsideration

If your claim is denied at the initial application stage, you can file a request for reconsideration. 

At the reconsideration stage, you can update your medical evidence.

Social Security may request that you complete some of the same forms that you completed when you first applied, and again it may schedule evaluations with doctors chosen by Social Security officials.

Different evaluators from the people who initially reviewed your case will give it a fresh look and decide your case at the reconsideration stage.

Social Security Disability Step 3: Administrative Law Judge Hearing

If your case is denied at the reconsideration stage, your next step will be requesting a hearing before a Social Security administrative law judge, or ALJ.

Your hearing usually will be scheduled within four to five months, although it can take longer.  

This is when the process gets more complicated and more like a legal case and when you definitely want to have a disability attorney.

Prior to your hearing, your disability attorney will submit all of your updated medical evidence.

Prior to your hearing, you’ll also meet for a prehearing conference.

(My next blog entry will discuss what occurs at a prehearing conference.)

At your hearing, the administrative law judge will ask you questions about your work history and medical conditions. Social Security may ask vocational and medical experts to testify about you. You could call your own witnesses.

This hearing is an opportunity to directly present why you feel you are unable to work and should get disability benefits.

Social Security Disability Step 4: Appeals Council

If you’re denied again at the ALJ hearing level, the next step will be for you to request review of the hearing decision before the Appeals Council.

The Appeals Council is a part of the SSA.

At Geary Disability Law, we argue in documents sent to the Appeals Council that the administrative law judge made errors of law that mean you should get a new hearing.

The Appeals Council usually denies requests for review, but for most of my clients, this stage is necessary because it keeps their claim going from the original date when they filed for disability benefits. If you continue fighting for your original claim and eventually win, you’ll win more back benefits covering the time period since you started.

If the Appeals Council actually takes up your case for review, it rarely makes a decision on awarding or denying your benefits. More likely, it will send your claim back to the ALJ with new instructions.

Making the decision to request a review before the Appeals Council, you need to be aware that you generally are not allowed to both request the review of your claim and file a new claim at the same time. 

And if you start a new claim right now, you’ll lose that accrued time for back pay that you could receive.

Social Security Disability Level 5: Federal District Court

If the Appeals Council denies your request for review, you will have the opportunity to file suit in federal court.

Now you’re stepping outside of Social Security’s own legal system and into the court system.

Although I generally don’t handle cases at this level, I assist my clients in finding attorneys who can take their cases to Federal District Court.

Unlike the Appeals Council level, you are allowed to file a new disability claim while you pursue an existing claim in Federal District Court.

And I typically do file new claims for my clients when they are at this stage.

If a client gets the Federal District Court to order a new disability hearing after filing a new claim, their new claim and old claim usually are joined together and proceed as one claim before the administrative law judge.

Like with the Appeals Council, the most likely positive result you can get from federal court is an order for a new ALJ hearing with new instructions from the court.

What if You Still Get Denied Disability Benefits after Suing in Federal Court?

There is still another level you can pursue if your federal court disability appeal doesn’t succeed: the U.S. Supreme Court.

Few disability cases go to the Supreme Court, so I wouldn’t consider it an expected part of the process.

And you have another option to continue fighting for disability benefits besides the Supreme Court: starting over with a new claim.

In filing a new claim, you’ll want to consider how your situation has changed—likely how your health has worsened—in a way that may give you a better chance of approval this time.

At Geary Disability Law, we’ve helped thousands of people in the Fox Valley and across Northeast Wisconsin win disability benefits.

After health problems disrupt your life and livelihood, we’re here to help you move forward. Contact us for help with your disability claim.

Written by Tim Geary.

Disclaimer: Blog entries are not intended to be a substitute for actual legal advice. It is important for a representative to understand the specific facts and circumstances of your case before they can provide you actual legal advice. If you have questions about your Social Security Disability benefits, please contact a qualified representative to discuss your case.