How Long Does a Disability Claim Take?
If you’re seeking Social Security Disability benefits, you’re likely wondering how long you’re going to have to wait until you receive your first payment. You’ve probably heard about backlogs at the Social Security Administration (SSA) and you may be concerned about how long the process will take.
The simple answer: it varies. The SSA says that it generally “takes about 3 to 5 months to get a decision” on an initial application. However, the majority of applications – even valid ones – are denied at first. Most claimants must work their way through a review and appeals process before actually recovering the benefits they deserve.
There is good news. If your claim is eventually approved, you may be entitled to receive back pay to five months after the date your disability began. Also, working with a qualified SSD attorney like the ones at Younce, Vtipil, Baznik & Banks, P.A., can help ensure all the required paperwork is filled out before the strict deadlines and advocate for your right to benefits every step of the way.
Disability Benefits Process Timeline
To provide a better idea about the SSD application and review process – and the times required for each step – consider the following timeline:
1. You Become Disabled
You become “disabled” for purposes of SSD benefits on the date when you can no longer perform “substantial gainful employment” due to a physical or mental impairment. Simply being unable to continue at your old job is not enough to qualify for benefits. You must be unable to do any substantial work and your disabling condition must last or be expected to last at least one year or end in death.
Here are some of the most common conditions that SSD applicants have:
|Musculoskeletal and connective tissue disorders||30.7%|
|Nervous system disorders||14.2%|
|Cardiovascular and circulatory system disorders||12.1%|
|Cancer and neoplasms (tumors)||9.0%|
|Respiratory system disorders||2.9%|
2. Your Doctor Diagnoses Your Condition
You need to go to a doctor as soon as possible after you become unable to work. The doctor may perform initial tests to diagnose your condition. These tests may include:
- CT scans
- Blood and/or other bodily fluid tests.
The results of these tests, your diagnosis and your treatment plan are very important to your SSD claim. They will make up much of medical evidence in your case. Be sure to tell your doctor how your condition has affected your ability to work.
3. You Get Help from a Lawyer
The sooner you talk to a lawyer about your claim, the better. Your attorney can review and evaluate your situation. Your attorney may suggest applying for SSD benefits as well as other benefits, such as:
- Workers’ compensation
- Black Lung benefits
- Civil Service disability retirement
- Veterans’ benefits
- Federal employees’ workers’ compensation
- Federal employees’ disability retirement
- State or local government disability insurance
- Private or employer-based disability plans
Your attorney can help you start the application process by compiling your information and collecting medical evidence.
4. You Apply for SSD Benefits
You can apply for disability benefits in three ways:
Online – You can fill out forms available at the SSA website.
By phone – You can apply by phone and follow it up by mailing in your documentation or taking to your nearest SSA office. The number to call is 1-800-772-1213 or 1-800-325-0778 (TTY). The number is available between 7 a.m. to 7 p.m. on business days. The interview should take about one hour.
5. Review of Your Initial Claim
The review of your SSD benefits claim will involve two parts:
- Non-medical eligibility – A local SSA representative will verify the information in your application and determine if your earnings record qualifies you to receive SSD benefits.
- Medical eligibility – The SSA will send your case to the Disability Determination Services (DDS) office. A two-person team (claims examiner and medical consultant) will determine if you meet the SSA’s strict definition of “disability.”
After the DDS team reaches it decision, it will send your claim back to the SSA office for processing. The SSA will send you either:
Notice of Award – If your claim is approved.
Notice of Denial – If your claim is rejected.
6. Disability Appeals Process – How Long Does a Social Security Appeal Take?
If your initial claim results in a denial, you are not alone. In fact, the SSA denies nearly two-thirds of initial applications. You have 60 days from the date on your Notice of Denial letter to file a written request for reconsideration. You should continue to appeal a denial of your claim through four more stages:
Reconsideration – Your file is re-reviewed and any additional medical evidence is submitted.
Hearing – The hearing would be held at Office of Disability Adjudication and Review (ODAR) office for your area. North Carolina offices are located in Charlotte, Fayetteville, Greensboro and Raleigh. The most recent statistics indicate that 48% of North Carolina cases are approved at the hearing stage. The average wait time for a hearing is 22.1 months in North Carolina. An administrative law judge (ALJ) will decide your case.
Appeals Council – Your case may be reviewed by the Appeals Council in Falls Church, Virginia. The average processing time is 386 days.
U.S. District Court – You can file a lawsuit in your nearest U.S. District Court.
7. You Collect Benefits on an Approved Claim
If your claim is approved, you will receive a Notice of Approval letter that will include details about:
- Your disability onset date
- Date you became eligible for benefits (five months after your disability onset date)
- Amount of back pay you will be awarded and when you will be paid
- Amount you will receive in monthly benefits and when you will be paid
- Date of your first continuing disability review (CDR)
8. You Undergo Continuing Disability Review (CDR)
The frequency of your CDRs depends on the severity of your disability.
- If medical improvement is expected – CDR 6-18 months from the start of your benefits
- If improvement is possible – CDR every 3 years
- If no improvement is expected – CDR every 5 to 7 years.Your benefits will continue unless you are determined to be no longer disabled.
How Long Does a Disability Claim Take? Infographic