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      1. Social Security Benefits
      2. General

      Social Security Process Overview

      A basic outline of what to expect over the course of your claim

      Once all required forms are received by our firm, we will get to work on your case.  As you can imagine, there are usually delays when dealing with government organizations and these delays fall out of our control.  Here is a brief overview of what to expect at various stages in the Social Security process.


      1. Initial applications


        In order to begin your application for benefits our office needs certain information to help us complete and start your claim.  We use questionnaires to gather most of the information we need.  If we need clarification we will call or email you.  If there are any questions you are struggling to complete, please call us.  

        Once the application is filed Social Security will begin to process the claim.  
        1. First, Social Security will send you a letter requesting that you attest to the application.  This must be signed and returned - please send us a copy if you are signing and returning directly to Social Security.  Otherwise, if you send the signed document to our office, we will submit it on your behalf. 
        2. You will likely also receive a call separately from Social Security requesting verbal confirmation that you have, indeed, retained our office to help you with your claim.  If they do not obtain confirmation, Social Security will not recognize us as your representative, and we will not be able to take any action on your behalf, or receive any updates on your case.  
        3. Once your claim has been initiated, Social Security will send you additional forms and questions to review and return.  Please only send these forms to our office so that we can review your responses, and if necessary, discuss any responses that may impact your eligibility. 
        4. We will request medical records and opinions based on the information you provide.  At the initial and Reconsideration levels, Social Security also requests records from every medical source you identify.  Because of this, we may not request your records from each and every provider you have seen, especially if we believe a particular provider may charge excessive fees, or the information is likely to be received by Social Security.  Instead, we will prioritize those doctors who treat you for your most significant conditions, and seek opinions from providers you have identified as likely supportive. 

      2. Request for Reconsideration


        If your claim is not awarded at the initial level, the first stage in appeal is to request Reconsideration, that is, to ask the agency to take a second look at your claim.  The approval odds at this stage are incredibly low (see chart below).  When we take a case after an initial denial, we never expect to win at this stage.  The statistics simply don't support that as likely.  Instead, we will use this time to further expand your record, and make sure Social Security hasn't ignored any important evidence.  

      3. Request for Hearing


        The Hearing stage is where we are most likely to win a previously denied claim.  If you review the chart below, nationally, administrative law judge's grant 45% of cases, dismiss 24% and deny 30%.  Dismissals should be ignored, as these are procedural issues, for example, when someone requests a hearing but does not show up, or withdraws their claim.  Therefore, only the awarded and denied claims should be reviewed.  Here, ALJ's grant 45% and deny 30%.  This means that, of the cases that are decided on the merits, ALJ's grant approximately 60% of cases.  

        While the chance for a good outcome increases at the hearing stage, the wait-time to have a hearing before a judge can reach to an average of 18 months or longer.  This is the unfortunate reality of this process.  By the time your case gets to someone who can spend the time to look at the facts, the delay becomes extraordinary.  

        Unless you are able to document dire circumstances that warrant your case being treated differently than other disability claimants who are also out of work without income, there is little we can do to speed up this process.  Be wary of any attorney or advocate who promises you speed when the speed is controlled by a government agency.  What we can do, is make sure your case is ready when it's your turn to be heard.  

      4. Appeals beyond the Hearing level


        A majority of Social Security attorneys do not represent their clients in appeals after a denial from a judge.  Economically, this makes sense: Appeals take a considerable amount of time to prepare a brief and to argue the case before the Appeals Council, and further to Federal Court if needed.  For representatives who are relatively passive, they build the win/loss averages into their model, and simply accept losing as much as 40% of their cases. 

        Our office has a different philosophy.  We believe that appealing unfavorable administrative law judge decisions is critical for a few reasons.  First: we often succeed.  Second: we believe that being willing to challenge a judge's decision means that the judge will take us more seriously, and know that, on a close case, if they get it wrong, we will appeal, get the decision reversed and bring it right back to them to handle again.  It helps us earn more benefit of the doubt.  It is also the right thing to do. 

        Note - we don't appeal every case.  The decision to appeal is based on a review of the judge's decision and whether we can identify errors in the decision based on the record that was before the judge that make it likely an appeal will succeed.  In some cases, where we simply differ from the judge's opinion, we may recommend filing a new claim instead.  Still, many denials are appeals, and we rarely give up on a case entirely.  

      5. Post Decision actions


        Once you've one your case, you will receive benefits.  The time between an award and receipt of benefits can take an average of about 90 days.  It's often sooner, and in some unusual cases, it may be further delayed.  

       

      This chart shows the outcome of decisions at each level of the appeals process.