For the majority of people, the process of applying for Social Security Disability benefits is not quick or easy. In fact, it can take anywhere from 4 months to 3 years for a claim to be approved. It is important to understand the different stages of the process and what is required in each stage to ensure Social Security is able to handle your claim as quickly as possible. The Initial Stage: The initial stage involves filing your application for benefits, and development and review of evidence by the Disability Determination Services (DDS). DDS has adjudicators that review, request records, and make decisions on your claim. During this process, it is common to receive forms requesting information about your daily activities, work history, or doctors and medications. These forms may feel repetitive, but are important to the development of your claim. If DDS feels you do not have enough evidence for them to make a decision, they might schedule you for a Consultative Exam (CE) with a doctor that works with Social Security. Once that exam is completed and the report is released, they will finish reviewing your claim and a decision will be made. At the initial stage, it takes roughly 4-6 months to receive a decision. The Reconsideration Stage: If your claim was denied at the initial stage you have 60 days from the date of the denial to file an appeal. Once the appeal has been filed, Social Security will send your claim over to DDS again for review. DDS will request any updated medical records and you could be scheduled for another Consultative Exam. It takes an average of 3-4 months to get a decision at the reconsideration stage. The Hearing Stage: If your claim was denied at the reconsideration stage, you again have 60 days from the date of the denial to file a request for a hearing. Typically, going to a hearing is your best chance of being approved for benefits. The hearing takes place in front of an Administrative Law Judge (ALJ) and you will receive a notice of hearing about 75 days before the hearing date. All medical records and supportive evidence must be obtained and submitted to the hearing office at least 3 weeks prior to the hearing. This allows the ALJ time to review the evidence before the hearing. In most situations, legal representation is required in order to go in front of the ALJ. If you do not have legal representation the judge may order a postponement allowing you time to find a representative. Having legal representation is your best chance for approval. While the hearing stage is the stage where you have the best chance of being approved, it is also the longest stage. The average national wait time to get a hearing scheduled is currently 18-20 months. After the hearing takes place, the ALJ often takes 2-6 months to release his or her decision. The Appeals Council: If your claim is denied at a hearing, your next option for an appeal would be requesting an appeal with the Appeals Council. The Appeals Council reviews the ALJ’s decision to determine whether or not an error may have been made based on the evidence on file. They can either agree with the ALJ’s decision, and deny the request to appeal, or they can Remand the case and send it back to the hearing office for another hearing. It can take up to 18 months to get a decision back from the Appeals Council. With all of the different steps and appeal processes, it is ideal to contact an attorney from the very beginning of the application process. Having the proper representation can not only help you avoid unnecessary denials, but gives you an expert to help you understand the process and answer your questions along the way. Contact our office today for a free evaluation. We would love to see if we can help you with your claim! Revision 19-4; Effective December 1, 2019 Persons who have applied for SSI, whose SSI application has been delayed longer than 90 days, may be certified under the appropriate MEPD program pending the SSI eligibility decision. Person(s) must meet all non-financial and financial MEPD criteria to be eligible including:
Consider the age of the person to determine if a disability determination is needed. The state office Disability Determination Unit (DDU) needs a disability determination if the person is younger than 65. DDU cannot make a disability determination decision unless 90 days have passed since the SSI date of application and SSA's disability decision is still pending. If SSA finds the person is not disabled after DDU has established a disability, DDU is required to follow SSA’s decision and eligibility must be denied. Staff must set a special review for the fifth month to monitor the final SSA decision on disability. Once an MEPD eligibility recipient becomes eligible for SSI, SSA will report the SSI eligibility to HHSC via the SDX system. Once the SDX information is received, TIERS will automatically deny MEPD coverage and activate the SSI coverage. This is not an adverse action because the person does not lose benefits. The above should be used only in situations where the processing of a SSI application has been delayed. Staff must verify and document that an SSI application has been filed. Note: If the person is age 65 or older, no disability determination is needed. Verify that the person has filed an application for SSI. Related PolicySSI Applications, B-7100 How long does SSD take to approve?Generally, it takes about 3 to 5 months to get a decision. However, the exact time depends on how long it takes to get your medical records and any other evidence needed to make a decision. * How does Social Security make the decision?
What's the quickest you can get disability?All SSDI claims are subject to a waiting period for benefits. The earliest payments can start is five months from the date that Social Security determines your disability began, based on the medical evidence you provide.
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Disability determination pending how long does it take
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