The Claims Process

The Claims Process

Typical Claims Process for a Social Security Disability Case

Initial Application

An Initial Application is filed in a social security administration office in person, over the phone, or online. The application goes to the applicant’s nearest SSA office. The file is then sent to Disability Determination Services (DDS) to determine if you are medically disabled. The DDS is responsible for obtaining the medical information needed from your doctors as well as consultative examining doctors that are paid by the Social Security Administration. Once DDS determines they have enough medical evidence they will make either a favorable or unfavorable decision. If you are found disabled, the DDS returns the file to the Social Security field office to assess the amount of your disability benefits. If the DDS denies your claim for disability benefits, you have the right to file an appeal within 60 days of your denial letter.

Appeals Process:

Request for Reconsideration
The first appeal is called the Reconsideration Appeal. It is filed with the local social security office, which will process and forward it to the state Disability Determination Service for case review.

Request for Hearing with an Administrative Law Judge
If the Reconsideration is denied as well, then a second appeal which is a Request for Hearing with the Administrative Law Judge is filed with the local office. From there the second appeal will be forwarded to the closest Social Security Judge's Office, which is called the Office of Disability and Review (ODAR). The wait time for a hearing is long, usually anywhere from 12-18 months and sometimes longer. If you win at this stage and your case is not reviewed by the Appeals Council, then it will be sent to local field office for payment. If the claim is denied at the ODAR, then another appeal can be made to the Appeals Council which is located in Falls Church Virginia.