If you are thinking about filing a claim for disability benefits with the Social Security Administration be prepared for a long and frustrating process. This federal agency is burdened with a huge case load which grew even larger, perhaps even doubled, with the recession starting in 2008. The SSA has made a concentrated effort to reduce the case load and to get a decision to claimants as early as possible, but long delays are still the norm. Every claim is different, but here is how your claim might proceed.
- I am no longer able to work due to illness or injury. What should I do? Start the process early! You can file your initial claim online, call your local SSA field office, or go to your local field office. If you want help and an early free evaluation of your claim click here.
- The state agency will get your claim and investigate it. This agency, in Colorado the Disability Determinations Service, will develop the file with you, order your medical records, have you fill out forms regarding your condition and ability to work, and then make a determination as to whether you are disabled. All locations differ as to the time frame, but four months is a safe estimate of when you can expect a determination. About 30 % of the applications in Colorado and in Denver are favorable by recent reporting. Not long ago the favorable rate was only 18%.
- We are now helping people like you at this stage of the process because we see so many claimants be denied by the DDS, even though the DDS has not received all of the important medical records, and having an incomplete file. We also can help with filling out forms if you need it. In some states—not Colorado—there is an intermediate step where you can ask for reconsideration if you receive an unfavorable determination from the DDS. This is a delay of four to six months in many jurisdictions.
- If you receive an unfavorable decision from the DDS you can initiate an appeal by filing a Request for Hearing. This can be done online or through your SSA office in person. This initiates the process where the local Office of Disability Adjudication and Review (ODAR) receives and further develops the file. This includes requesting additional medical records, often sending you for an examination by a physician or other medical provider, having you fill out additional forms relating to your functioning, and then having a hearing before federal Administrative Law Judge (ALJ). The amount of time you must wait before you get a hearing varies widely throughout the country. In Colorado from the time you request a hearing until the day of your hearing averages 14-18 months, though it is getting shorter.
- If you receive a favorable ruling from the ALJ your local SSA field office will contact you and start setting up benefit payments. This can vary from a few months to many months of further delay.
- If you receive an unfavorable decision from the ALJ you have 60 days (plus a maximum of 5 days for mailing) to appeal to another administrative agency within SSA’s ODAR office, the Appeals Council. The AC will take another 14-18 months as an average to respond with either a remand for further consideration (back to the same ALJ the first time), or deny your appeal. Only about 25% of appeals are favorable to the claimant. If you win with the AC you have to wait for another hearing before the same local ALJ. In a miniscule portion of cases the AC will direct payment of benefits. If you have appealed twice to the AC and won, the AC will remand to a different ALJ.
- If your appeal is denied you can consider filing a claim with the United States District Court. Again you have 60 days to file. A very small portion of all claims filed result in United States District Court filings. The courts may direct payment to you (rare) or remand to the SSA for further consideration. If you do not receive favorable treatment at the district court level you can appeal to the Court of Appeals, or even the United States Supreme Court if the court will agree to hear your case.
- As you can see it is important to try to get benefits as early as possible, to make your file complete and as strong as possible early, and to get help EARLY in the process. For a free consultation and review of your claim click here.
If your disability carrier denies you the benefits you are entitled to receive call us to discuss your claim. This is a no cost initial conference. It is important to call us before you have completed your claim process with the insurance carrier because we will not be able to supplement your file, even if the administrative appeals with your carrier is incomplete. This may result in you not being able to support your claim in the courts, because you cannot present testimony or additional evidence. We help by making sure your medical and vocational evidence is in or file, and that your carrier considers all your evidence.
If you are denied by your carrier, get us on board to be your advocates. We understand what you are going through. We will help you. Call (303) 996-0700, or send us an email through this web site with your contact information. Tell us about your claim.
Please be aware that this information is not legal advice, but is supplied to give you information about the process. The attorney client relationship is only formed by written agreement. We give legal advice only in the office by appointment. We look forward to hearing from you.