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Who
Qualifies?
How
to Apply
What
You Will Need When You Apply
What
Happens After Your Application is Filed
When
and How To Appeal
The
Four Appeal Steps
Step
1 - Reconsideration
Step
2 - Hearing
Step
3 - Appeals Council Review
Step
4 - Federal Court Action
Your
Right to Representation
For
More Information
Who
Qualifies?
You
must have worked long enough and recently enough to
qualify for Social Security Disability Insurance
Benefits. Generally,
for persons over age 30, the work must have been
performed in 5 out of the last 10 years.
There are special rules for younger
individuals.
Disability
under Social Security is based on your inability to
work. You
will be considered disabled if you are unable to do
any kind of work for which you are suited and your
disability is expected to last for at least a year
or result in death.
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How
to Apply
You
may start your claim by calling Social Security’s
toll-free number:
(800) 772-1213. You may file by phone, mail, or in person at any Social
Security Administration office.
To find your local Social Security office,
call (800) 772-1213 or visit the Social Security
web-site at www.ssa.gov.
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What
You Will Need When You Apply
When
you file your claim with Social Security, you will
need to provide:
-
Your
Social Security Number
-
Your
certified Birth Certificate
-
W-2
forms for the last 2 years (if you had wages
during those years)
-
The
names, addresses, and phone numbers of your
doctors, clinics, and hospitals
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What
Happens After Your Application is Filed
Social
Security will consider all the information in your
case before making a decision about your eligibility
for disability benefits. They will request medical
records and will send forms to your doctors. They may contact you for additional information.
They may also ask you to see one of their
doctors. Social Security disability applications
generally take 3 to 4 months to process.
If
Social Security decides that you are not eligible
for benefits, they will send you a notice explaining
the decision. If
you don’t agree with the decision, an “appeal”
can be filed.
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When
And How To Appeal
Appeals
must be requested in
writing within 60 days
from the date of the denial notice.
Failure to file a timely appeal could result
in a loss of benefits.
Social Security assumes you receive the
denial notice within 5 days after the date sent unless you
can show you received it later. A Disability Services (DSI) advocate can assist you with your
appeal.
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The
Four Appeal Steps
 There
are four appeal steps in most States.
The steps are usually taken in order.
They are:
-
Reconsideration*,
-
Hearing
by an Administrative Law Judge,
-
Appeals
Council review, and
-
Federal
Court review.
*
In October 1999, as part of a program to
redesign the disability process, the reconsideration
step was eliminated in the following ten States:
Alabama, Alaska, Colorado, Louisiana,
Michigan, Missouri, New Hampshire, Pennsylvania,
parts of California and part of New York.
When Social Security sends a notice about the
decision on your claim, they will tell you what
appeal step you may take and will give you
information about how the appeal step works.
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Step
1 – Reconsideration*
A
reconsideration is a complete review of your claim
by someone who didn’t take part in the first
decision. Social
Security will look at all the evidence submitted
when the original decision was made plus any new
evidence. They
will make a new decision and send you a notice.
Social Security reconsiderations generally
take 3 to 4 months to process.
A
Disability Services (DSI) Advocate can assist you
with your reconsideration.
*
Eliminated in ten states.
See The Four
Appeal Steps above.
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Step
2 – Hearing
If
you disagree with the reconsideration decision, you
may ask for a hearing.
An Administrative Law Judge who had no part
in the first decision or the reconsideration of your
case will conduct the hearing.
Claimants who have an advocate to represent
them are more likely to win.
Due
to current backlogs, hearings are usually scheduled
within 12 to 18 months of the date you file your
appeal. The
hearing is usually held within 75 miles of your
home. The
Administrative Law Judge will notify you and your
representative of the time and place of the hearing.
You
and your representative may attend the hearing and
explain your case in person.
You may look at the information in your file
and give new information.
The
Administrative Law Judge will make a decision based
on all the information in your case, including any
new information given at the hearing.
Social Security will send you and your
representative a copy of the Administrative Law
Judge’s decision.
A
Disability Services (DSI) Advocate can assist you
with your hearing.
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Step
3 –Appeals Council Review
If
you disagree with the hearing decision, you and/or
your representative may ask for a review by Social
Security’s Appeals Council. Your representative may prepare and submit written arguments
in support of your claim.
The Appeals Council may take one of the
following actions:
-
Deny
your request for review
-
Remand
your case for a new hearing
-
Make
a favorable decision
You
and your representative will receive a copy of the
Appeals Council’s decision.
Based on current backlogs, Appeals Council
reviews generally take about 2 years to process.
A
Disability Services (DSI) Advocate can assist you
with your request for Appeals Council review.
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Step
4 – Federal Court Action
If
you disagree with the Appeals Council’s decision
or if the Appeals Council decides not to review your
case, a lawsuit may be filed in Federal district
court.
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Your
Right To Representation
Many
people try to handle their own Social Security
appeals, but you can choose a qualified advocate to
help you. Someone
you appoint to help you is called your “representative”.
Social Security will work with your
representative throughout the appeals process.
Your
representative can act for you in most Social
Security matters and should receive a copy of any
decisions Social Security makes about your claim.
A Disability Services (DSI) Advocate can
assist you at any step of your claim or appeal.
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For
More Information
If
you have questions about your right to appeal, call
our toll-free number,
1-800-374-9950
or contact us via e-mail.
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