Did You Know? Social Security Claims Process

DID YOU KNOW? When adults apply for Social Security, it is generally for Supplemental Security Income (“SSI”) or Social Security Disability (“SSD”). SSI is need based, and SSD is based upon each individuals work history (for more information, see our last blog post).

When you apply, your initial application is reviewed by Social Security, and a decision is made. Most people are denied.

If you are in fact denied, you file a Reconsideration. This is where you ask Social Security to look again at your application. You can submit additional evidence (medical records, doctor reports, ect.). Social Security makes another decision, and most people are denied.

It is then that you file a Request for a Hearing in front of an administrative law judge (ALJ). These are independent judges who conduct a hearing on your application for benefits. At the hearing, the ALJ will take testimony from you concerning your application, your work history and your medical problems. Your representative, if you have one, is present and can also ask you questions. Your representative can make arguments to the ALJ on your behalf.

Waiting for a hearing in front of an ALJ is a very lengthy process. Right now (11-3-2016), we are seeing wait times in excess of two years. This is a problem common to all attorneys - we have no input on the scheduling of hearings and there is a large back log of applications. That’s why it’s important to have quality representation when your time comes. It’s a tough road to wait such a long time for a hearing, and you need someone there with you to make sure everything is in order.

Most people who are awarded are successful at the hearing stage of the process. If you are not approved, you have two options: 1) file a new claim, starting the process over or 2) appeal the ALJ’s decision.

If you appeal, Social Security has established an “Appeals Council” who will look at the decision of the ALJ. At the initial application, reconsideration and hearing, the question for Social Security to answer is whether you are disabled. This is not true for the Appeals Council: they look to see whether the ALJ made any errors of law or failed to base their decision on substantial evidence (or as we like to say, “whether the ALJ followed the law and provided a viable reason for their decision”). This is a much tougher standard because the focus is no longer as simple as determining whether you are disabled.

The Appeals Council can: 1) overturn the decision of the ALJ and send your case back to the ALJ with instruction to award benefits, 2) can overturn the decision of the ALJ and send your case back with instructions to hold another hearing and address certain matters, or 3) affirm the ALJ’s decision.

If the Appeals Council affirms the decision of the ALJ, you can file a new claim or you can file a lawsuit against the Social Security Administration is federal court, which proceeds like a regular lawsuit.

We have been successful at getting people awarded at the every stage of the process, including the initial application. We have experience filing lawsuits against the Social Security Administration. We are not perfect. Not everyone gets awarded. But we do fight for you! If you would like to file for social security, call any of our offices - we are standing by to help you!

Disclaimer: If you or someone you know was injured as a result of the negligence of another, call one of our offices. We have a team of highly skilled lawyers standing by to assist you. This article is for informative purposes only and is no substitute for advice with an attorney fully informed about the facts of a specific matter. This does not constitute an offer of representation nor does it create an attorney-client relationship. THIS IS AN ADVERTISEMENT.

Categories: Social Security

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