When you apply, a claims representative will ask you to submit any medical records you have concerning your condition and give you a letter to take to your doctor for more information. Although you are not required to submit records or obtain information from your doctor, it may speed up your claim if you do. Tip: If you can, get copies of all of your relevant medical records and bring them to the application appointment. Do not let an inability to get these records keep you from filing, however. Social Security will get the records if you do not.
Your file is transferred to a regional office where it is assigned to a disability analyst who will evaluate your claim. The analyst will obtain your medical records and, in most cases, arrange for you to be seen for a medical evaluation by a doctor paid by Social Security. Tip: Call you analyst to make sure all of your records are being collected and to report new doctors or other sources that may have information about your disability.
Once the analyst has your medical records and any other reports or evidence
which has been requested, a decision on your claim is made. You will be
notified by mail whether your claim has been granted or denied. It typically
takes about three months from the date you apply until you receive a decision.
If your claim is denied you have 60 days (plus 5 days for mailing) from
the date on the denial letter to appeal. To appeal you must file a form
called a Request for Reconsideration.
Tip: If possible, hand deliver the reconsideration request to Social
Security and ask for a date-stamped copy which is your proof that
you filed the appeal. Always keep copies of any records you give to Social
Security.
The reconsideration process works the same way as the initial application process described above, except a different analyst evaluates the case and usually you are not sent to another doctor. The analyst will collect updated records from the medical sources you have reported and make a new decision. Again, you will be notified by letter whether your claim has been granted or denied. It typically takes about two months from the time you file the Request for Reconsideration until you receive the decision. If your claim is denied you have 60 days (plus 5 days for mailing) from the date on the denial letter to appeal. You appeal by filing a Request for Hearing.
At the hearing stage you will have an opportunity to appear in front
of an Administrative Law Judge (ALJ) to testify under oath about your condition
and the reasons your disabilities preclude you from working. The majority
of claimants at this stage choose to be represented by an attorney or non-attorney
advocate.
Tip: Begin trying to find a representative as soon as you receive
the reconsideration denial. Do not wait to file your Request for Hearing
until you have a representative; file the hearing request immediately upon
receiving the denial letter.
The ALJ may grant the case without holding a hearing. If the judge decides a hearing is necessary, it will likely be a year or longer until the hearing is held. Ultimately, the ALJ issues a written decision stating the reasons your claim has been granted or denied. If the judge grants the case "on the record" (i.e., without holding a hearing), the decision may be received in less than six months. If a hearing is held, it can take ten or more months to receive a decision. If your case was denied and you did not have a representative, we strongly advise that you consult an attorney or other experienced advocate who can explain all options available to you and assist you with appealing your case to the next level.
This information is very basic. There are many aspects to the application
procedure we did not cover in this article. If you have questions, call
The Hawkins Center to discuss the specifics of your situation.