We’re pleased to offer basic information about Social Security’s adult disability programs. (Remember – there’s much more to the disability program than appears here.) Experienced staff at DHI will be happy to answer any questions you may have. We may be able to assist you file an application, even if you’ve been denied benefits in the past. Our toll-free number is 800-670-6274.
- Social Security administers two disability programs:
- The Social Security disability program is an insurance program based on one’s earnings. (Social Security Disability Insurance = SSDI)
- The Supplemental Security disability program is a program based on one’s need. (Supplemental Security Income = SSI)
- Three Field Components Operate the Disability Program
- The Social Security Office (SSO) takes applications and makes non-medical determinations.
- The Disability Determination Services (DDS) makes medical determinations – the most complicated part of the disability decision.
- The Office of Disability Adjudication and Review (ODAR) handles disputed appeals of both medical and non-medical issues.
Why does it take so long to make a disability determination?
Not all decisions take long, but many do. The documentation requirements for a disability decision are detailed. Congress requires that DDS obtain records from all treating sources within the time of the disability – even if some sources didn’t treat you for the disabling condition. If the sources mention another treating source the DDS didn’t know about, DDS must purchase consultative examinations. So it’s not unusual for the process to stretch into 120 days.
If the decision is unfavorable, you may appeal. Then the DDS restarts the cycle, which takes time. If the reconsideration decision is unfavorable, and you appeal to ODAR, the average wait is 400 days – about 13 months.
Steps to Getting SSDI or SSI Benefits
Step One: Initial Application
File your initial application and supporting documents with your local Social Security Administration office.
Step Two: Reconsideration Level
If you are denied benefits on your initial application, you may request that your case be reconsidered within 60 days of receiving your denial letter. The most common mistake that an applicant can make is not to appeal.
Step Three: Hearing Level
If your claim is denied after the Reconsideration Level, you have 60 days to request a hearing. This hearing will be held before an administrative law judge. He or she will review medical evidence, listen to witnesses and decide your case.
Step Four: Appeals Council Level
If your case is not allowed at the Hearing Level, you may file a written appeal to be considered by a special department in the Social Security Administration. The Appeals Council reviews your case to determine whether you were given a fair hearing. If you are successful, your case will likely be referred back to the Administrative Law Judge for further review.
Step Five: Federal Court Level
If the Appeals Council denies your appeal and/or refuses to review your case, you have 60 days to file for a review of your case in the Federal District Court. A federal judge will review your case and will (1) award you disability benefits, (2) deny you disability benefits, or (3) send your case back for a hearing before an Administrative Law Judge again.